1538755566 NPI number — A PEACEFUL MIND MENTAL HEALTH SERVICES

Table of content: (NPI 1538755566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538755566 NPI number — A PEACEFUL MIND MENTAL HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A PEACEFUL MIND MENTAL HEALTH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538755566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 VILLAGE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAZLET
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07730-1535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-297-8849
Provider Business Mailing Address Fax Number:
231-251-8123

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 VILLAGE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZLET
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07730-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-297-8849
Provider Business Practice Location Address Fax Number:
231-251-8123
Provider Enumeration Date:
12/14/2020

Additional Information

Authorized Official

Authorized Official Last Name:
ARAVICH
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
Authorized Official Title or Position:
NURSE PRACTITIONER/OWNER
Authorized Official Telephone Number:
908-297-8849

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1144727736 . This is a "NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com