MEDICARE: PEACE OF MIND CMH CORP

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1972193522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND CMH CORP

Provider Business Mailing Address
First Line	:	4973 SW 74TH CT STE 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4471
Country	:	US
Telephone Number	:	305-283-6254
Fax Number	:

Provider Business Practice Location Address
First Line	:	4973 SW 74TH CT STE 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4471
Country	:	US
Telephone Number	:	305-283-6254
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACQUELINE GARCIA
Credential	:
Telephone Number	:	305-283-6254

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	01/25/2021

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Directions to “PEACE OF MIND CMH CORP ” Practice Location

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