# PEACH RETREAT HOME CARE

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

## Provider details

- **NPI number:** 1831842368
- **Authorized official:** MRS. LABOCCIA OGUNLEWE RN (CEO)
- **Authorized official phone:** (727) 483-3477

## Contact information

- **Practice address:** 3260 LAMBTOWN RD, VIENNA, GA 31092-7102
- **Practice address phone:** (229) 521-1051
- **Mailing address:** 3260 LAMBTOWN RD, VIENNA, GA 31092-7102
- **Mailing address phone:** (229) 521-1051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 02/03/2022
- **Last updated:** 10/11/2023