Healthcare Provider Details

I. General information

NPI: 1013475193
Provider Name (Legal Business Name): PEACE OF MIND ADULT DAYCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4283 MILLBRANCH RD
MEMPHIS TN
38116
US

IV. Provider business mailing address

1470 TRAFALGAR CV
SOUTHAVEN MS
38671-8988
US

V. Phone/Fax

Practice location:
  • Phone: 901-581-3686
  • Fax:
Mailing address:
  • Phone: 901-581-3686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CORRY HAWKINS
Title or Position: OWNER
Credential:
Phone: 901-581-3686