Healthcare Provider Details

I. General information

NPI: 1669391801
Provider Name (Legal Business Name): A PEACE OF MIND COMMUNITY SUPPORT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 TWINRIDGE LANE
NORTH CHESTERFIELD VA
23235-5720
US

IV. Provider business mailing address

713 TWINRIDGE LANE
NORTH CHESTERFIELD VA
23235-5720
US

V. Phone/Fax

Practice location:
  • Phone: 804-925-9329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LATESHA MCINTOSH-SMITH
Title or Position: SECRETARY
Credential: LCSW
Phone: 804-925-9329