Provider Demographics
NPI:1083436497
Name:MA BELL'S HOUSE OF PEACE INC.
Entity type:Organization
Organization Name:MA BELL'S HOUSE OF PEACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:PIPHUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-406-6710
Mailing Address - Street 1:PO BOX 16644
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-0644
Mailing Address - Country:US
Mailing Address - Phone:414-406-6710
Mailing Address - Fax:414-763-0926
Practice Address - Street 1:5572 W ROOSEVELT DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3152
Practice Address - Country:US
Practice Address - Phone:414-406-5000
Practice Address - Fax:414-763-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care