A Peace of Mind Wellness LLC
Organization Active NPI Community/Behavioral Health Agency · Toledo, OH
NPI 1295320786 · NPPES record last updated Nov 15, 2022
Key facts
- NPI
- 1295320786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- A PEACE OF MIND WELLNESS LLC
- Practice address
- 5734 Douglas Rd
Toledo, OH 43613-2038 - Phone
- (419) 724-1500
- Fax
- (419) 724-1616
- NPI assigned
- Mar 5, 2021
- Organization subpart
- No
Authorized official
- Name
- Jennifer Fackelman, LISW-S, LICDC-CS
- Title
- Cco
- Phone
- (419) 724-1500
Corporate family (same tax ID) 1
Practitioners 18
-
Wayman Farmer, CDCA
-
Laylah Jones, QMHS 3YR
-
Jennifer Peer, LSW
-
Katherine Roe, LISW
-
Abigail Duhaime, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221115000166 | OH | Part B Supplier - Clinic/Group Practice | 9638547151 |
Receives reassigned benefits from 1 practitioner Practice locations: Toledo, OH |
National Provider Directory
- Tax ID family
- A Peace of Mind Wellness
Locations
5734 Douglas Rd
Toledo, OH 43613
Phone (419) 472-1500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
5734 Douglas Rd
Toledo, OH 43613-2038
Mailing address
5734 Douglas Rd
Toledo, OH 43613-2038
Phone (419) 724-1500
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All providers in Toledo, OH · Community/Behavioral Health Agency in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.