Provider Demographics
NPI:1063384196
Name:A PEACEFUL PLACE HOME HEALTH LLC
Entity type:Organization
Organization Name:A PEACEFUL PLACE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATIKA
Authorized Official - Middle Name:TARA
Authorized Official - Last Name:HANDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CBRF
Authorized Official - Phone:414-467-2689
Mailing Address - Street 1:2551 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-2054
Mailing Address - Country:US
Mailing Address - Phone:414-467-2689
Mailing Address - Fax:
Practice Address - Street 1:2551 N 19TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206-2054
Practice Address - Country:US
Practice Address - Phone:414-467-2689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health