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General NPI Number Information
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NPI Number | 1215570296
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 995 N KENNEDY DR
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City | KANKAKEE
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State | IL
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Zip | 60901-2236
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Country | US
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Telephone | 815-450-7100
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Fax | 815-304-4415
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Provider Business Mailing Address
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Address Line | 995 N KENNEDY DR
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City | KANKAKEE
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State | IL
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Zip | 60901-2236
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Country | US
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Telephone | 815-450-7100
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Fax | 815-304-4415
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDSAY WARREN
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Credential |
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Telephone | 815-450-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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