Provider Demographics
NPI:1316663909
Name:PEACE OF MIND FAMILY SERVICES, LLC.
Entity type:Organization
Organization Name:PEACE OF MIND FAMILY SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LA TANYA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MANOR JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC-I
Authorized Official - Phone:702-807-1882
Mailing Address - Street 1:3281 CHEYENNE GARDENS WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8921
Mailing Address - Country:US
Mailing Address - Phone:702-518-4033
Mailing Address - Fax:
Practice Address - Street 1:5071 N RAINBOW BLVD STE 170
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-1688
Practice Address - Country:US
Practice Address - Phone:702-518-4033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100561093Medicaid