Provider Demographics
NPI:1043985799
Name:CITY OF PEACE HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:CITY OF PEACE HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:IBEH
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:202-560-4899
Mailing Address - Street 1:2423 NICOL CIR
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2907
Mailing Address - Country:US
Mailing Address - Phone:202-560-4899
Mailing Address - Fax:
Practice Address - Street 1:8727 GREENBELT RD STE 201
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2491
Practice Address - Country:US
Practice Address - Phone:202-560-4899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)