Provider Demographics
NPI:1659606143
Name:PEACE OF MIND HUMAN SERVICE, INC.
Entity Type:Organization
Organization Name:PEACE OF MIND HUMAN SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:MATTHEWSON
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-795-4267
Mailing Address - Street 1:PO BOX 1386
Mailing Address - Street 2:107 WEST ACEDEMY STREET
Mailing Address - City:ROBERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27871-1386
Mailing Address - Country:US
Mailing Address - Phone:252-795-4267
Mailing Address - Fax:252-795-4267
Practice Address - Street 1:107 WEST ACDEMY STREET
Practice Address - Street 2:107 WEST ACEDEMY STREET
Practice Address - City:ROBERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27871-1386
Practice Address - Country:US
Practice Address - Phone:252-795-4267
Practice Address - Fax:252-795-4267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health