| Peace Reconnection Care, Pllc | |
|
16006 Ronda Dale Dr Hockley TX 77447-7714 | |
| (601) 600-6752 | |
| Not Available |
| Full Name | Peace Reconnection Care, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 16006 Ronda Dale Dr, Hockley, Texas |
| Authorized Official Name and Position | Marvshricka Quinn (OWNER) |
| Authorized Official Contact | 6016006752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace Reconnection Care, Pllc 16006 Ronda Dale Dr Hockley TX 77447-7714 Ph: (601) 600-6752 | Peace Reconnection Care, Pllc 16006 Ronda Dale Dr Hockley TX 77447-7714 Ph: (601) 600-6752 |
| NPI Number | 1447828892 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 06/14/2021 |
| Certification Date | 06/10/2021 |
| Medicare PECOS PAC ID | 2365842192 |
|---|---|
| Medicare Enrollment ID | O20210615002741 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447828892 | NPI | - | NPPES |
| 0 | Other | N/A |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Marvshricka Quinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821559444 PECOS PAC ID: 1456750728 Enrollment ID: I20210519001741 |
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