Provider Demographics
NPI:1386915452
Name:A PEACE OF MIND ADULT DAY HEALTH CARE CENTER, INC.
Entity type:Organization
Organization Name:A PEACE OF MIND ADULT DAY HEALTH CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HENDERSON-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:678-945-9290
Mailing Address - Street 1:3565 AUSTELL RD SW
Mailing Address - Street 2:SUITE 1063
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-5769
Mailing Address - Country:US
Mailing Address - Phone:770-438-0999
Mailing Address - Fax:
Practice Address - Street 1:3565 AUSTELL RD SW
Practice Address - Street 2:SUITE 1063
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-5769
Practice Address - Country:US
Practice Address - Phone:770-438-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-22
Last Update Date:2012-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care