Provider Demographics
NPI:1902468846
Name:PEACEABLE LIFE THERAPEUTIC SERVICES, INC.
Entity Type:Organization
Organization Name:PEACEABLE LIFE THERAPEUTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MENEIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-414-4561
Mailing Address - Street 1:PO BOX 962
Mailing Address - Street 2:
Mailing Address - City:STUARTS DRAFT
Mailing Address - State:VA
Mailing Address - Zip Code:24477-0962
Mailing Address - Country:US
Mailing Address - Phone:540-414-4561
Mailing Address - Fax:877-363-9068
Practice Address - Street 1:2857 STUARTS DRAFT HWY UNIT 121
Practice Address - Street 2:
Practice Address - City:STUARTS DRAFT
Practice Address - State:VA
Practice Address - Zip Code:24477-2692
Practice Address - Country:US
Practice Address - Phone:540-414-4561
Practice Address - Fax:877-363-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty