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Organization
INNER PEACE LIVING, INC
Active
Organization
INNER PEACE LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRESHIA MARTIN RN,BSN (OWNER/CEO)
(769) 217-0209
Entity
Organization
Contact information
Practice address
1174 OLD INDUSTRIAL RD, MCCOMB, MS 39648-9407
(601) 600-2170
Mailing address
1174 OLD INDUSTRIAL RD, MCCOMB, MS 39648-9407
(769) 217-0209
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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