=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427858885
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PENIEL HOME HEALTH SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2025
-----------------------------------------------------
Last Update Date | 12/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9896 BISSONNET ST STE 315
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-8153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-318-5725
-----------------------------------------------------
Fax | 713-405-2722
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9896 BISSONNET ST STE 315
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-8153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-619-4533
-----------------------------------------------------
Fax | 713-405-2722
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR/NURSE SUPERVISOR
-----------------------------------------------------
Name | KATE ANIM KORANTENG
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 346-318-5725
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------