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NPI 1427745694

NPI 1427745694 : TRUE PEACE OF MIND LLC : RANDOLPH, MA

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General NPI Number Information
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    NPI Number           |    1427745694
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRUE PEACE OF MIND LLC 
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Dates
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    Enumeration Date     |    04/19/2023
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    Last Update Date     |    04/19/2023
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Provider Practice Location Address
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    Address Line         |    306 CHESTNUT ST 
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    City                 |    RANDOLPH
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    State                |    MA
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    Zip                  |    02368-2441
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    Country              |    US
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    Telephone            |    857-488-0632
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    306 CHESTNUT ST 
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    City                 |    RANDOLPH
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    State                |    MA
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    Zip                  |    02368-2441
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    Country              |    US
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    Telephone            |    857-488-0632
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JACOB KILSON PAGE 
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    Credential           |    LMHC
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    Telephone            |    857-488-0632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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