Healthcare Provider Details

I. General information

NPI: 1134683543
Provider Name (Legal Business Name): PEACE OF MIND HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N RAINBOW BLVD STE 300
LAS VEGAS NV
89107-1061
US

IV. Provider business mailing address

10141 ROCKRIDGE PEAK AVE
LAS VEGAS NV
89166-5200
US

V. Phone/Fax

Practice location:
  • Phone: 412-708-2482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL NWOKIKE
Title or Position: OWNER
Credential:
Phone: 412-708-2482