Peace Of Mind Functional Medicine

LBN: Peace Of Mind Functional Medicine
Peace Of Mind Functional Medicine is an health care organization with primary practice located at 151 Sw Shevlin Hixon Dr Ste 201 , Bend OR 97702-3233. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Adolescent and Children Mental Health is the primary health care specialty. Peace Of Mind Functional Medicine can be contacted via phone (458) 202-9231, or through Coppedge, Mary Kate via phone (541) 222-9231.

Contact Information

Primary practice address
151 Sw Shevlin Hixon Dr Ste 201 Bend OR 97702-3233
Phone: (458) 202-9231
Fax: (541) 797-6113
Website:
Map and Directions
Authorized official contact:
Name: Coppedge, Mary Kate PMHNP
Phone: (541) 222-9231

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1083240386
LBN Legal business name Peace Of Mind Functional Medicine
DBA Doing business as
Authorized official Coppedge, Mary Kate PMHNP
Entity Organization
Organization subpart 1 No
Enumeration date Mar 18th, 2020
Last updated Mar 18th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083240386 NPPES
Oregon MEDICAID 1194057661

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