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General NPI Number Information
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NPI Number | 1720139900
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Entity Type | Organization
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Legal Business Name | PENACO HOME HEALTH CARE
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14111 TORREY VILLAGE DR
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City | HOUSTON
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State | TX
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Zip | 77014-1829
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Country | US
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Telephone | 281-586-9616
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Fax | 281-586-9292
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Provider Business Mailing Address
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Address Line | 14111 TORREY VILLAGE DR
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City | HOUSTON
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State | TX
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Zip | 77014-1829
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Country | US
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Telephone | 281-586-9616
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Fax | 281-586-9292
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | MRS. CHINELO OGBONNE OKEKE
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Credential | BSC. MICROBIOLOGY
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Telephone | 281-703-7389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | TX
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