Provider Demographics
NPI:1285412874
Name:P.E.A.C.E MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:P.E.A.C.E MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIQUANA
Authorized Official - Middle Name:CHERIE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:804-979-8611
Mailing Address - Street 1:22063 CASCADE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-7158
Mailing Address - Country:US
Mailing Address - Phone:804-979-8611
Mailing Address - Fax:
Practice Address - Street 1:22063 CASCADE MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-7158
Practice Address - Country:US
Practice Address - Phone:804-979-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty