Provider Demographics
NPI:1740143767
Name:WALK IN PEACE
Entity type:Organization
Organization Name:WALK IN PEACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:B
Authorized Official - Last Name:NGALIEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-317-7412
Mailing Address - Street 1:41 HUTCHINS DR # 3
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-1931
Mailing Address - Country:US
Mailing Address - Phone:207-405-9769
Mailing Address - Fax:
Practice Address - Street 1:41 HUTCHINS DR STE 18
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1931
Practice Address - Country:US
Practice Address - Phone:207-405-9769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)