Provider Demographics
NPI:1356652507
Name:A PEACE OF MIND HOME CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:A PEACE OF MIND HOME CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MERKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-462-3172
Mailing Address - Street 1:3155 HICKORY HILL RD
Mailing Address - Street 2:STE 106 B
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2555
Mailing Address - Country:US
Mailing Address - Phone:901-462-3172
Mailing Address - Fax:866-759-0806
Practice Address - Street 1:3155 HICKORY HILL RD
Practice Address - Street 2:STE 106 B
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2555
Practice Address - Country:US
Practice Address - Phone:901-462-3172
Practice Address - Fax:866-759-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445255Medicaid