Healthcare Provider Details

I. General information

NPI: 1689046211
Provider Name (Legal Business Name): PEACE OF MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 S BUSINESS 31 SUITE C
PERU IN
46970-7312
US

IV. Provider business mailing address

2484 S BUSINESS 31 SUITE C
PERU IN
46970-7312
US

V. Phone/Fax

Practice location:
  • Phone: 765-472-2722
  • Fax: 765-472-2722
Mailing address:
  • Phone: 765-472-2722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: KATINA ANN EVERDING
Title or Position: OWNER
Credential: APN
Phone: 765-472-2722