Organization Name: | PENROSE AVENUE LLC |
NPI Number: | 1720498728 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RHONDA HARPER (MANAGING PARTNER & CEO) |
Mailing Address: | 6224 Penrose Ave Dallas |
State: | TX US |
Postal Code: | 752143040 |
Phone Number: | 8668948488 |
Fax Number: | |
NPI Enumeration Date: | 04/30/2014 |
NPI Last Update Date: | 04/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |