Organization
PALACE OF PEACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANISHA MOORE (PRESIDENT/ADMINISTRATOR)
(904) 559-5327
Entity
Organization
Contact information
Practice address
5436 101ST ST APT 3, JACKSONVILLE, FL 32210-8910
(904) 559-5327
Mailing address
PO BOX 28582, JACKSONVILLE, FL 32226-8582
(904) 559-5327
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
05/24/2022
Last updated
05/11/2023
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