Provider Demographics
NPI:1386322238
Name:PEACE & GRACE INSURANCE SERVICES LLC
Entity type:Organization
Organization Name:PEACE & GRACE INSURANCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEP
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CIC
Authorized Official - Phone:209-812-4026
Mailing Address - Street 1:1210 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-4041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1210 3RD ST
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-4041
Practice Address - Country:US
Practice Address - Phone:209-812-4026
Practice Address - Fax:209-580-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare