MEDICARE: PEACE OF MIND HOME HEALTH CARE AGENCY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1225647605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND HOME HEALTH CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	4223 HARRISON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-3379
Country	:	US
Telephone Number	:	513-544-8908
Fax Number	:

Provider Business Practice Location Address
First Line	:	4223 HARRISON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-3379
Country	:	US
Telephone Number	:	513-544-8908
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STANLEY THOMAS
Credential	:
Telephone Number	:	513-290-0113

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	10/11/2021

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