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General NPI Number Information
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NPI Number | 1073452538
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Entity Type | Organization
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Legal Business Name | PENIEL RTC INC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 1115 ARMADILLO RD
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City | ROSENBERG
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State | TX
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Zip | 77471-9073
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Country | US
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Telephone | 346-527-4460
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Fax |
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Provider Business Mailing Address
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Address Line | 6907 NORTHCHESTER DR
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City | KATY
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State | TX
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Zip | 77493-3850
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Country | US
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Telephone | 346-527-4460
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. HARRIET ADESUWA EVBUOMWAN
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Credential |
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Telephone | 248-497-4458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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