# PEACEFUL HEALTH AND RESIDENTIAL SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235794850
- **Authorized official:** PRINCE GYENIN (ADMINISTRATOR)
- **Authorized official phone:** (703) 785-8567

## Contact information

- **Practice address:** 5088 TWO CHIMNEYS CT, WOODBRIDGE, VA 22193-3264
- **Practice address phone:** (703) 785-8567
- **Practice address fax:** (703) 897-7507
- **Mailing address:** 5088 TWO CHIMNEYS CT, WOODBRIDGE, VA 22193-3264
- **Mailing address phone:** (703) 785-8567
- **Mailing address fax:** (703) 897-7507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2019
- **Last updated:** 05/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5088 | — | VA |