Provider Demographics
NPI:1619353687
Name:PEACE OF MIND ADULT CARE HOME
Entity Type:Organization
Organization Name:PEACE OF MIND ADULT CARE HOME
Other - Org Name:GROUP HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-464-1796
Mailing Address - Street 1:88 FOREST ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9612
Mailing Address - Country:US
Mailing Address - Phone:919-300-1152
Mailing Address - Fax:919-300-1152
Practice Address - Street 1:143 RAY DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-5567
Practice Address - Country:US
Practice Address - Phone:919-300-1152
Practice Address - Fax:919-300-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities