Provider Demographics
NPI:1275417578
Name:FAITH AND PEACE AFH
Entity type:Organization
Organization Name:FAITH AND PEACE AFH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAVON
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-322-4595
Mailing Address - Street 1:3314 W ORIOLE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4101
Mailing Address - Country:US
Mailing Address - Phone:414-322-4595
Mailing Address - Fax:414-446-5836
Practice Address - Street 1:3314 W ORIOLE DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-4101
Practice Address - Country:US
Practice Address - Phone:414-322-4595
Practice Address - Fax:414-446-5836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities