MEDICARE: PEACE OF MIND LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	320800000X	Mental Illness Community Based Residential Treatment Facility
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
5	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194435016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND LIVING

Provider Business Mailing Address
First Line	:	5650 W 73RD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1738
Country	:	US
Telephone Number	:	317-468-5323
Fax Number	:

Provider Business Practice Location Address
First Line	:	5650 W 73RD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1738
Country	:	US
Telephone Number	:	317-468-5323
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSELYN MERRIWEATHER
Credential	:
Telephone Number	:	317-468-5323

Provider Enumeration Date	:	12/01/2022
Last Update Date	:	12/08/2022

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Directions to “PEACE OF MIND LIVING ” Practice Location

Language	Start Address	Practice Location

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