Provider Demographics
NPI:1942935630
Name:PENIEL-TREASURE CARE SERVICES LLC
Entity Type:Organization
Organization Name:PENIEL-TREASURE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NDEME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-939-9514
Mailing Address - Street 1:1227 BELL TOWER ARCH
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-3176
Mailing Address - Country:US
Mailing Address - Phone:443-932-9514
Mailing Address - Fax:
Practice Address - Street 1:1227 BELL TOWER ARCH
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3176
Practice Address - Country:US
Practice Address - Phone:443-932-9514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care