# PEAUCHEE PASSION

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

## Provider details

- **NPI number:** 1942639638
- **Authorized official:** MS. BRENDA J MUNSEY (OWNER)
- **Authorized official phone:** (740) 438-7515

## Contact information

- **Practice address:** 121 SECOND ST, PLEASANTVILLE, OH 43148-0224
- **Practice address phone:** (740) 438-7515
- **Mailing address:** PO BOX 224, 121 SECOND ST, PLEASANTVILLE, OH 43148-0224
- **Mailing address phone:** (740) 438-7515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | OH | Yes |

## Other

- **Enumeration date:** 11/04/2013
- **Last updated:** 11/04/2013