Provider Demographics
NPI:1013660612
Name:PEACE OF MIND FAMILY HOME CARE, LLC
Entity Type:Organization
Organization Name:PEACE OF MIND FAMILY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLEMONTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-202-9693
Mailing Address - Street 1:1408 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3549
Mailing Address - Country:US
Mailing Address - Phone:336-938-0080
Mailing Address - Fax:
Practice Address - Street 1:2216 W MEADOWVIEW RD STE 269
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3406
Practice Address - Country:US
Practice Address - Phone:336-646-2975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEACE OF MIND FAMILY HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-02
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No291U00000XLaboratoriesClinical Medical Laboratory
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child