Provider Demographics
NPI:1720853575
Name:PEACE HEALTHCARE INC
Entity Type:Organization
Organization Name:PEACE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEWAAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-499-4707
Mailing Address - Street 1:501 GRANARY RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-3042
Mailing Address - Country:US
Mailing Address - Phone:667-276-4302
Mailing Address - Fax:667-276-4303
Practice Address - Street 1:501 GRANARY RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-3042
Practice Address - Country:US
Practice Address - Phone:667-276-4302
Practice Address - Fax:667-276-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty