Peace Reconnection Care, PLLC

Organization Active NPI Mental Health Counselor · Hockley, TX

NPI 1447828892 · NPPES record last updated Jun 14, 2021

Key facts

NPI
1447828892
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
PEACE RECONNECTION CARE, PLLC
Practice address
16006 Ronda Dale Dr
Hockley, TX 77447-7714
Phone
(601) 600-6752
NPI assigned
Jun 14, 2021
Organization subpart
No

Authorized official

Name
Marvshricka Quinn, LCSW
Title
Owner
Phone
(601) 600-6752

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210615002741 TX Part B Supplier - Clinic/Group Practice 2365842192 Receives reassigned benefits from 1 practitioner
Practice locations: Cypress, TX

National Provider Directory

Locations

14150 Huffmeister Rd
Ste 200203
Cypress, TX 77429
Phone (281) 214-0413

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

16006 Ronda Dale Dr
Hockley, TX 77447-7714

Mailing address

16006 Ronda Dale Dr
Hockley, TX 77447-7714
Phone (601) 600-6752

Other identifiers

IdentifierTypeStateIssuer
0OtherN/A

Other providers in Hockley, TX

All providers in Hockley, TX · Mental Health Counselor in Texas

Sources for this page

Verify at the official NPI Registry.