Organization
PEACE PROGRAM
Active
Other names
PEACE Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LORENZO L SMITH II (BOARD PRESIDENT)
(937) 248-1402
Entity
Organization
Contact information
Practice address
3214 HOOVER AVE, DAYTON, OH 45402-5320
(937) 248-1402
Mailing address
3214 HOOVER AVE, DAYTON, OH 45402-5320
(937) 248-1402
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/06/2024
Last updated
09/18/2024
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