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General NPI Number Information
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NPI Number | 1538979067
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Entity Type | Organization
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Legal Business Name | PEACEFULMIND BEHAVIORAL LLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 112 N CENTRAL AVE STE 112
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City | PHOENIX
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State | AZ
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Zip | 85004-2309
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Country | US
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Telephone | 682-382-4062
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Fax | 682-382-4050
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Provider Business Mailing Address
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Address Line | 7312 DARSENA GRAND
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City | PRAIRIE
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State | TX
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Zip | 75054
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Country | US
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Telephone | 682-382-4062
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SMINK ACHILA
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Credential | APRN-BC
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Telephone | 682-382-4062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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