Provider Demographics
NPI:1912698416
Name:A PLACE OF PEACE PERSONAL CARE LLC
Entity Type:Organization
Organization Name:A PLACE OF PEACE PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-964-9199
Mailing Address - Street 1:1700 NORTHSIDE DRIVE
Mailing Address - Street 2:STE. A7 PMB 3200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318
Mailing Address - Country:US
Mailing Address - Phone:678-600-3298
Mailing Address - Fax:
Practice Address - Street 1:1082 BOCA RATON DR
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-3445
Practice Address - Country:US
Practice Address - Phone:678-600-3298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty