Provider Demographics
NPI:1124627765
Name:PEACE CARE SERVICES LLC
Entity type:Organization
Organization Name:PEACE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:ACHEKH
Authorized Official - Last Name:OUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:BHP
Authorized Official - Phone:207-577-4017
Mailing Address - Street 1:145 LISBON ST STE 508
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7241
Mailing Address - Country:US
Mailing Address - Phone:207-577-4017
Mailing Address - Fax:
Practice Address - Street 1:145 LISBON ST STE 508
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7241
Practice Address - Country:US
Practice Address - Phone:207-577-4017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-24
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health