Organization
A PEACEFUL LIFE HOME CARE & COMPANION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKENYA LATANZA GREEN (SOLE OWNER)
(813) 580-6363
Entity
Organization
Contact information
Practice address
2664 N MCMULLEN BOOTH RD APT 614, CLEARWATER, FL 33761-4065
(813) 580-6363
Mailing address
2664 N MCMULLEN BOOTH RD APT 614, CLEARWATER, FL 33761-4065
(813) 580-6363
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/01/2021
Last updated
01/14/2022
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