Healthcare Provider Details

I. General information

NPI: 1649885302
Provider Name (Legal Business Name): PEACE OF MIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4354 E HARMON AVE
LAS VEGAS NV
89121-6514
US

IV. Provider business mailing address

4354 E HARMON AVE
LAS VEGAS NV
89121-6514
US

V. Phone/Fax

Practice location:
  • Phone: 702-419-3594
  • Fax:
Mailing address:
  • Phone: 702-419-3594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MAEGAN PADILLA
Title or Position: OWNER
Credential:
Phone: 702-419-3594