# PEACE WELLNESS CENTER, LLC

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

## Provider details

- **NPI number:** 1306111984
- **Authorized official:** MRS. PAMELA JARRETT FNP,BC (CEO)
- **Authorized official phone:** (601) 842-7107

## Contact information

- **Practice address:** 638 NORTHWEST AVE, DURANT, MS 39063-3337
- **Practice address phone:** (601) 842-7107
- **Practice address fax:** (800) 517-7659
- **Mailing address:** PO BOX 93, VAIDEN, MS 39176-0093
- **Mailing address phone:** (601) 842-7107
- **Mailing address fax:** (800) 517-7659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | R869034 | MS | Yes |

## Other

- **Enumeration date:** 03/15/2012
- **Last updated:** 03/15/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03607748 | — | MS |