MEDICARE: PENDLETON HOME SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1356207146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENDLETON HOME SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	105 OAKLAND AVE
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32773-6237
Country	:	US
Telephone Number	:	407-391-1098
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 OAKLAND AVE
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32773-6237
Country	:	US
Telephone Number	:	407-391-1098
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	TAMEKA MCDANIEL
Credential	:
Telephone Number	:	407-391-1098

Provider Enumeration Date	:	12/24/2025
Last Update Date	:	07/05/2026

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Directions to “PENDLETON HOME SOLUTIONS LLC ” Practice Location

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