Healthcare Provider Details

I. General information

NPI: 1093251928
Provider Name (Legal Business Name): WIHELMENA CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9502 ROSEHAVEN DR
HOUSTON TX
77051-3131
US

IV. Provider business mailing address

5301 BRETT DR
PEARLAND TX
77584-1236
US

V. Phone/Fax

Practice location:
  • Phone: 832-621-9359
  • Fax:
Mailing address:
  • Phone: 832-621-9359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number666663
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number666663
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number666663
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number666663
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number666663
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number666663
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number666663
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number666663
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number666663
License Number StateTX
# 10
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number666663
License Number StateTX
# 11
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number666663
License Number StateTX
# 12
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number666663
License Number StateTX
# 13
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number666663
License Number StateTX
# 14
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number666663
License Number StateTX
# 15
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number666663
License Number StateTX

VIII. Authorized Official

Name: PEGGY PENN
Title or Position: OWNER/MANAGER
Credential: BSN, MBA/HCM
Phone: 832-621-9359