Provider Demographics
NPI:1326401613
Name:A PEACE OF MIND CAREGIVING
Entity Type:Organization
Organization Name:A PEACE OF MIND CAREGIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:SIMONE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-406-3099
Mailing Address - Street 1:3275 POWERS RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-3443
Mailing Address - Country:US
Mailing Address - Phone:901-406-3099
Mailing Address - Fax:901-249-5265
Practice Address - Street 1:3275 POWERS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-3443
Practice Address - Country:US
Practice Address - Phone:901-406-3099
Practice Address - Fax:901-249-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000017998311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ020343Medicaid