Provider Demographics
NPI:1104548627
Name:PEACE OF PI LLC
Entity type:Organization
Organization Name:PEACE OF PI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:423-330-0010
Mailing Address - Street 1:15592 N 136TH LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-5383
Mailing Address - Country:US
Mailing Address - Phone:423-330-0010
Mailing Address - Fax:
Practice Address - Street 1:18434 N 99TH AVE STE 8
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85373-1672
Practice Address - Country:US
Practice Address - Phone:423-330-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)