Provider Demographics
NPI:1487314100
Name:PEACE OF MIND LLC
Entity type:Organization
Organization Name:PEACE OF MIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYSTER-BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-226-5281
Mailing Address - Street 1:414 LIGHT ST UNIT 1301
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-1269
Mailing Address - Country:US
Mailing Address - Phone:443-226-5281
Mailing Address - Fax:
Practice Address - Street 1:2862 OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5313
Practice Address - Country:US
Practice Address - Phone:443-226-5281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness