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Organization
PEACEFUL HEALTH AND RESIDENTIAL SERVICE
Active
Organization
PEACEFUL HEALTH AND RESIDENTIAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRINCE GYENIN (ADMINISTRATOR)
(703) 785-8567
Entity
Organization
Contact information
Practice address
5088 TWO CHIMNEYS CT, WOODBRIDGE, VA 22193-3264
(703) 785-8567
(703) 897-7507
Mailing address
5088 TWO CHIMNEYS CT, WOODBRIDGE, VA 22193-3264
(703) 785-8567
(703) 897-7507
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5088
—
VA
Enumeration date
05/08/2019
Last updated
05/08/2019
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