Healthcare Provider Details

I. General information

NPI: 1356207146
Provider Name (Legal Business Name): PENDLETON HOME SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 OAKLAND AVE
SANFORD FL
32773-6237
US

IV. Provider business mailing address

105 OAKLAND AVE
SANFORD FL
32773-6237
US

V. Phone/Fax

Practice location:
  • Phone: 407-391-1098
  • Fax:
Mailing address:
  • Phone: 407-391-1098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMEKA MCDANIEL
Title or Position: SOLE MEMBER
Credential:
Phone: 407-391-1098