Provider Demographics
NPI:1952823478
Name:PENZI HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:PENZI HOME HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGOCHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-217-0798
Mailing Address - Street 1:169 MCKNIGHT RD N APT 120
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-4694
Mailing Address - Country:US
Mailing Address - Phone:651-217-0798
Mailing Address - Fax:651-217-0798
Practice Address - Street 1:169 MCKNIGHT RD N APT 120
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-4694
Practice Address - Country:US
Practice Address - Phone:651-217-0798
Practice Address - Fax:651-217-0798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health