Provider Demographics
NPI:1619648029
Name:A PEACE OF MIND HEALTH & WELLNESS
Entity Type:Organization
Organization Name:A PEACE OF MIND HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-807-4726
Mailing Address - Street 1:1430 E INDIAN SCHOOL RD STE 230
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4991
Mailing Address - Country:US
Mailing Address - Phone:702-807-4726
Mailing Address - Fax:
Practice Address - Street 1:1430 E INDIAN SCHOOL RD STE 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4991
Practice Address - Country:US
Practice Address - Phone:702-807-4726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health