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General NPI Number Information
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NPI Number | 1871136416
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Entity Type | Organization
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Legal Business Name | PENIEL HOME CARE LLC
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 5551 NW 125TH TER
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3432
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Country | US
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Telephone | 866-473-6435
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Fax |
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Provider Business Mailing Address
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Address Line | 5551 NW 125TH TER
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3432
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COE/ADMINISTRATOR
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Name | MS. SHERLEY MARC
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Credential |
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Telephone | 786-985-1209
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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 |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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