Organization
PEACEHAVEN BEHAVIORAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEACE IBEAWUCHI BANKS NP (PMHNP)
(336) 991-3491
Entity
Organization
Contact information
Practice address
2175 NW RALEIGH ST STE 110, PORTLAND, OR 97210-2392
(737) 231-0823
Mailing address
3916 N POTSDAM AVE, SIOUX FALLS, SD 57104-7048
(737) 231-0823
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
10/17/2024
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