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General NPI Number Information
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NPI Number | 1356580419
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND DIRECT
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 1206 W HILLSDALE BLVD SUITE D
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City | SAN MATEO
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State | CA
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Zip | 94403-3197
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Country | US
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Telephone | 650-520-7854
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 W HILLSDALE BLVD STE D
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City | SAN MATEO
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State | CA
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Zip | 94403-3127
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Country | US
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Telephone | 650-520-7854
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SHAUN ARCENEAUX
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Credential |
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Telephone | 650-520-7854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 101194103
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License Number State | CA
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