| Organization Name: | PEACEFUL MENTAL HEALTH ASOCIATE, LLC |
| NPI Number: | 1386902252 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARAH ELIZABETH JOHNSON (OWNER) |
| Mailing Address: | 105 South 9th Ave. Wauchula |
| State: | FL US |
| Postal Code: | 33873 |
| Phone Number: | 8637730002 |
| Fax Number: | 8637736389 |
| NPI Enumeration Date: | 04/30/2012 |
| NPI Last Update Date: | 04/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH10369 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |