Provider Demographics
NPI:1487246138
Name:PEACEFUL MINDS HOME MANAGEMENT & PERSONAL CARE LLC
Entity type:Organization
Organization Name:PEACEFUL MINDS HOME MANAGEMENT & PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-422-6347
Mailing Address - Street 1:1509 WICKHAM POND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-9231
Mailing Address - Country:US
Mailing Address - Phone:434-205-4863
Mailing Address - Fax:
Practice Address - Street 1:1244 OLD TRAIL DR
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3379
Practice Address - Country:US
Practice Address - Phone:434-205-4863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based