Provider Demographics
NPI:1962084954
Name:ADVOCATING FOR PEACE, LLC
Entity type:Organization
Organization Name:ADVOCATING FOR PEACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ QMHP-A
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PANKEY
Authorized Official - Suffix:
Authorized Official - Credentials:BA QMHP-A/C
Authorized Official - Phone:804-219-9554
Mailing Address - Street 1:2819 N PARHAM RD STE 260
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4425
Mailing Address - Country:US
Mailing Address - Phone:804-219-9554
Mailing Address - Fax:
Practice Address - Street 1:2819 N PARHAM RD STE 260
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4425
Practice Address - Country:US
Practice Address - Phone:804-219-9554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3485Medicaid