MEDICARE: PELEZA HOME HEALTHCARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578150058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PELEZA HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	10935 ESTATE LN STE 119
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-2421
Country	:	US
Telephone Number	:	469-206-0395
Fax Number	:

Provider Business Practice Location Address
First Line	:	10935 ESTATE LN STE 119
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-2421
Country	:	US
Telephone Number	:	469-206-0395
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	EVALYNE NYANGAU
Credential	:
Telephone Number	:	214-434-6218

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	11/09/2021

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Directions to “PELEZA HOME HEALTHCARE LLC ” Practice Location

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