Provider Demographics
NPI:1194435016
Name:PEACE OF MIND LIVING
Entity type:Organization
Organization Name:PEACE OF MIND LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRIWEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-468-5323
Mailing Address - Street 1:5650 W 73RD ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1738
Mailing Address - Country:US
Mailing Address - Phone:317-468-5323
Mailing Address - Fax:
Practice Address - Street 1:5650 W 73RD ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1738
Practice Address - Country:US
Practice Address - Phone:317-468-5323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1427667344Medicaid