Healthcare Provider Details

I. General information

NPI: 1144930488
Provider Name (Legal Business Name): PEACE OF MIND CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 11/28/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 CEDAR VILLAGE DR
MASON OH
45040-3701
US

IV. Provider business mailing address

5180 CEDAR VILLAGE DR
MASON OH
45040-3701
US

V. Phone/Fax

Practice location:
  • Phone: 513-810-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIANA SIMPSON
Title or Position: CLINICAL COORDINATOR
Credential:
Phone: 513-810-3627