Peace in the Valley Health Care Agency LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PEACE IN THE VALLEY HEALTH CARE AGENCY LLC

Practice address

719 Long LN FL 1
Upper Darby, PA 19082-5323

Phone

(267) 597-1862

NPI assigned

Apr 10, 2018

Last updated

Apr 10, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victor Kak

Title

President

Phone

(267) 597-1862

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184121865. Details of each certification follow.

• CCN 398323 Home health agency · Active · Details

Home health agency certification: CCN 398323

Legal name

PEACE IN THE VALLEY HEALTH CARE AGENCY LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 25, 2021

Last certification

Feb 25, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Mar 16, 2018 in PA

Enrollment address

7107 W Chester Pike
Upper Darby, PA 19082-1706

Listed as

Peace in the Valley Health Care Agency, LLCCCN 398323 · All quality measures

Ownership

Proprietary

Certified

Feb 25, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Physical therapy, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1184121865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 GRIFFITH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112931",
            "telephone_number": "267-597-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 LONG LN FL 1",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190825323",
            "telephone_number": "267-597-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE IN THE VALLEY HEALTH CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "KAK",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-597-1862"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.