Organization
PEACE ALLIANCE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENNIE RUKARWA (MEMBER)
(317) 238-0595
Entity
Organization
Contact information
Practice address
3360 COLD HARBOR DR, INDIANAPOLIS, IN 46227-9643
(317) 238-0595
Mailing address
3360 COLD HARBOR DR, INDIANAPOLIS, IN 46227-9643
(317) 238-0595
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251E00000X
Home Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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