Organization
PEACEFUL PEAKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURTASHA WALLER QMHPP (OWNER/PROGRAM DIRECTOR)
(276) 806-9615
Entity
Organization
Contact information
Practice address
317 BROWN ST, MARTINSVILLE, VA 24112-3801
(276) 806-9615
Mailing address
51 SHUMATE DR, COLLINSVILLE, VA 24078-1652
(276) 806-9615
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
12/03/2024
Last updated
05/19/2025
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