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General NPI Number Information
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NPI Number | 1659656981
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Entity Type | Organization
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Legal Business Name | A PEACEFUL MIND OF CARE SERVICES, LLC
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 620 JOHNS LANDING WAY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-6347
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Country | US
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Telephone | 678-377-2233
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Fax | 678-262-3522
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Provider Business Mailing Address
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Address Line | 3628 CAPE LN
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City | CONYERS
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State | GA
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Zip | 30013-6731
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Country | US
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Telephone | 404-966-4626
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Fax | 678-262-3522
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MRS. ADRIENNE M JOHNSON
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Credential |
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Telephone | 404-966-4626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | GA
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