Organization
PEACE WELLNESS MOBILE UNIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY PEEPLES (OWNER)
(601) 292-7015
Entity
Organization
Contact information
Practice address
502 MULBERRY ST, REAR BLDG, VAIDEN, MS 39176-9648
(601) 292-7015
(866) 884-6508
Mailing address
502 MULBERRY ST, REAR BLDG, VAIDEN, MS 39176-9648
(601) 292-7015
(866) 884-6508
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09753895
—
MS
Enumeration date
05/05/2017
Last updated
05/05/2017
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