Provider Demographics
NPI:1053074096
Name:A PEACE OF MIND ADULT FAMILY HOMES
Entity Type:Organization
Organization Name:A PEACE OF MIND ADULT FAMILY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TENISHA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:MAXEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-394-7506
Mailing Address - Street 1:PO BOX 18664
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-0664
Mailing Address - Country:US
Mailing Address - Phone:414-394-7506
Mailing Address - Fax:
Practice Address - Street 1:5296 N 73RD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2821
Practice Address - Country:US
Practice Address - Phone:414-394-7506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child