| A Peace Of Mind Wellness Llc | |
|
5734 Douglas Rd Toledo OH 43613-2038 | |
| (419) 724-1500 | |
| (419) 724-1616 |
| Full Name | A Peace Of Mind Wellness Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5734 Douglas Rd, Toledo, Ohio |
| Authorized Official Name and Position | Jennifer Fackelman (CCO) |
| Authorized Official Contact | 4197241500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Peace Of Mind Wellness Llc 5734 Douglas Rd Toledo OH 43613-2038 Ph: (419) 724-1500 | A Peace Of Mind Wellness Llc 5734 Douglas Rd Toledo OH 43613-2038 Ph: (419) 724-1500 |
| NPI Number | 1295320786 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 9638547151 |
|---|---|
| Medicare Enrollment ID | O20221115000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295320786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jennifer Fackelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578828984 PECOS PAC ID: 9931539269 Enrollment ID: I20200428001525 |
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