=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164333290
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEACE OF MIND HOME HEALTHCARE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2026
-----------------------------------------------------
Last Update Date | 09/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12 WOLF CREEK DR STE 100
-----------------------------------------------------
City | SWANSEA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62226-2314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-230-4336
-----------------------------------------------------
Fax | 618-215-6556
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12 WOLF CREEK DR STE 100
-----------------------------------------------------
City | SWANSEA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62226-2314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-230-4336
-----------------------------------------------------
Fax | 618-215-6556
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. GARY MAURICE SHULER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 618-230-4336
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------