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General NPI Number Information
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NPI Number | 1083452221
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Entity Type | Organization
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Legal Business Name | PENIEL HEALTHCARE DBA PENIEL HOMECARE
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Dates
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Enumeration Date | 07/19/2024
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 3050 MACK RD STE 350
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City | FAIRFIELD
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State | OH
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Zip | 45014-5392
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Country | US
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Telephone | 804-714-9625
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 MACK RD STE 350
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City | FAIRFIELD
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State | OH
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Zip | 45014-5392
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Country | US
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Telephone | 513-393-5166
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Fax | 513-808-9584
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Authorized Official
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Title or Position | PMHNP
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Name | MRS. EUNICE POKUA ADU
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Credential | NURSE PRACTIONER
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Telephone | 513-393-5166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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