Provider Demographics
NPI:1740843739
Name:MIND AT PEACE INC
Entity type:Organization
Organization Name:MIND AT PEACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TANYEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-509-1895
Mailing Address - Street 1:5058 BLACK CHAW ST
Mailing Address - Street 2:
Mailing Address - City:INDIAN HEAD
Mailing Address - State:MD
Mailing Address - Zip Code:20640-3729
Mailing Address - Country:US
Mailing Address - Phone:202-509-1895
Mailing Address - Fax:
Practice Address - Street 1:5058 BLACK CHAW ST
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-3729
Practice Address - Country:US
Practice Address - Phone:202-509-1895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care