Provider Demographics
NPI:1447346374
Name:INNER PEACE AFC HOME INC.
Entity type:Organization
Organization Name:INNER PEACE AFC HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME PROVIDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-885-4206
Mailing Address - Street 1:20283 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1631
Mailing Address - Country:US
Mailing Address - Phone:313-885-4206
Mailing Address - Fax:313-499-5483
Practice Address - Street 1:20283 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1631
Practice Address - Country:US
Practice Address - Phone:313-885-4206
Practice Address - Fax:313-499-5483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home