Provider Demographics
NPI:1386424158
Name:ECUMENISM FOR PEACE INTEGRATED HEALTHCARE & SOCIAL SERVICES
Entity type:Organization
Organization Name:ECUMENISM FOR PEACE INTEGRATED HEALTHCARE & SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/ADM.
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:IGWE
Authorized Official - Last Name:AGUBE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, LPN, BENG CQC
Authorized Official - Phone:623-707-6554
Mailing Address - Street 1:10332 W ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2690
Mailing Address - Country:US
Mailing Address - Phone:602-538-2543
Mailing Address - Fax:
Practice Address - Street 1:9800 W PEORIA AVE STE 2
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6148
Practice Address - Country:US
Practice Address - Phone:623-707-6554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ECUMENISM FOR PEACE ORGANIZATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty