MEDICARE: PEACE OF MIND

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	:	1245416254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND

Provider Business Mailing Address
First Line	:	2028 WILLOW WAY
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39204-4858
Country	:	US
Telephone Number	:	601-559-3215
Fax Number	:

Provider Business Practice Location Address
First Line	:	2028 WILLOW WAY
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39204-4858
Country	:	US
Telephone Number	:	601-559-3215
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	VELETA ESCO
Credential	:	CNA
Telephone Number	:	601-559-3215

Provider Enumeration Date	:	01/21/2008
Last Update Date	:	01/21/2008

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Directions to “PEACE OF MIND ” Practice Location

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