Provider Demographics
NPI:1225607583
Name:PEACE OF MIND HEALTHCARE MANAGEMENT , LIMITED LIABILITY COMPANY RSA-3
Entity Type:Organization
Organization Name:PEACE OF MIND HEALTHCARE MANAGEMENT , LIMITED LIABILITY COMPANY RSA-3
Other - Org Name:PEACE OF MIND HEALTHCARE MANAGEMENT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CNA/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARITA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:843-312-1741
Mailing Address - Street 1:6 STABLE RUN CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5320
Mailing Address - Country:US
Mailing Address - Phone:843-312-1741
Mailing Address - Fax:
Practice Address - Street 1:6 STABLE RUN CT
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5320
Practice Address - Country:US
Practice Address - Phone:843-312-1741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health