Provider Demographics
NPI:1316546823
Name:PEACEFUL MINDS RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:PEACEFUL MINDS RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:443-759-8601
Mailing Address - Street 1:3704 S HANOVER ST UNIT 2A2B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225-1773
Mailing Address - Country:US
Mailing Address - Phone:443-759-8601
Mailing Address - Fax:
Practice Address - Street 1:3704 S HANOVER ST UNIT 2A2B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1773
Practice Address - Country:US
Practice Address - Phone:443-759-8601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children