Organization
PRINCE OF PEACE HOME HEALTHCARE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IMELDA G PRAKELT LPN (PRESIDENT)
(520) 868-0250
Entity
Organization
Contact information
Practice address
10640 N 28TH DR STE A101, PHOENIX, AZ 85029-2908
(602) 441-3501
(602) 865-1970
Mailing address
10640 N 28TH DR STE A101, PHOENIX, AZ 85029-2908
(602) 441-3501
(602) 865-1970
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
34308
AZ
Other
Enumeration date
10/17/2012
Last updated
04/30/2013
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