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General NPI Number Information
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NPI Number | 1366829665
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND HOME CARE
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 615 N 9TH ST
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City | IMMOKALEE
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State | FL
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Zip | 34142-2902
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Country | US
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Telephone | 239-465-5775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2057
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City | IMMOKALEE
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State | FL
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Zip | 34143-2057
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Country | US
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Telephone | 239-465-5775
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. EVENS VOLCY
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Credential |
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Telephone | 239-465-5775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 18697
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License Number State | FL
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