# OUR LADY OF PEACE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Highland Block Nurse Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366989139
- **Authorized official:** JOSEPH STANISLAV (CEO/PRESIDENT)
- **Authorized official phone:** (651) 789-5049

## Contact information

- **Practice address:** 2076 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4543
- **Practice address phone:** (651) 696-8425
- **Mailing address:** 2076 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 347C00000X | Private Vehicle | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 01/31/2017
- **Last updated:** 06/08/2017