PENIEL HOUSE, LLC


Address: 724 Yorkshire Dr, Clayton, NC 27520-2973
Phone: 9194368298

PENIEL HOUSE, LLC (NPI# 1700322765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700322765
Entity Type Organization
Organization Name PENIEL HOUSE, LLC
Practice Address 724 Yorkshire Dr
Clayton
NC 27520-2973
Mailing Address 201 Steel Hopper Way
Garner
NC 27529-7358
Practice Telephone 9194368298
Mailing Telephone 9194368298
Enumeration Date 2017-01-16
Last Update Date 2017-01-16
Authorized Official Name MRS. LATASHIA EDWARDS (EXECUTIVE DIRECTOR)
Authorized Official Telephone 9194368298
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Office Location

Street Address 724 YORKSHIRE DR
City CLAYTON
State NC
Zip Code 27520-2973

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336750959 Ebony Nichole Sanders Driver 312 Kilgo, Clayton, NC 27520 2020-08-17
1831701382 Deawna Jackson Social Worker 205 Gracie Lane, Clayton, NC 27520 2020-08-17
1952947798 Mac Partners LLC Home Health 10027 Hwy 70 Business, Suite B, Clayton, NC 27520 2019-11-26
1386291102 Benjamin R Anderson Physician Assistant 2138 Nc 42, Clayton, NC 27520 2019-08-26
1396217923 Lindsey R. Williams Dds, Pa Dentist 45 Shotwell Rd., Clayton, NC 27520 2018-12-20
1063987303 Christopher James Lane Physician Assistant 2076 Nc 42 W, Suite 230, Clayton, NC 27520 2018-10-12
1245733971 Cordelia O Emebo Pharmacist 11360 Old Us Hwy 70 West, Clayton, NC 27520 2018-03-08
1487166906 Kendall Bonot Rodgers Physician Assistant 11491 Us 70 Bus Hwy W, Clayton, NC 27520 2017-10-25
1033620828 Laura Nguyen Physician Assistant 2076 Nc-42, Suite 230, Clayton, NC 27520 2017-10-19
1467974394 Liliana Galvan Social Worker 510 W Main St., Suit 100, Clayton, NC 27520 2017-07-12
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1396256285 Heart To Heart Health Care Services, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4 Still Run, Clayton, NJ 08312-2451 2017-10-18
1215448196 Heart To Heart Health Care Services, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 6 Still Run, Clayton, NJ 08312-2451 2017-10-18
1881105765 Heart To Heart Health Care Services, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 8 Still Run, Clayton, NJ 08312-2451 2017-10-18
1356852305 Heart To Heart Health Care Services, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2 Still Run, Clayton, NJ 08312-2451 2017-10-17
1669982153 Assoc. for Retarded Citizens, Inc. Gloucester County Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1 East Clayton Avenue, Clayton, NJ 08312 2017-10-10
1801277439 Personalized Independent Living Opporuntities & Training Services Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 519 Roosevelt Blvd, Clayton, NJ 08312-2055 2015-06-09
1558496075 Rha Health Services Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2318 Huntsbridge Dr, Clayton, NC 27520-8629 2007-02-23
1922438449 Medical West Healthcare Center LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 444 S Brentwood Blvd, Clayton, MO 63105-2521 2013-11-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306455126 A Place 4 Me, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5305 Clearwater Lake Rd, Mount Holly, NC 28120-1445 2020-07-28
1922623792 Our Home At Home LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4601 Waterford Knoll Dr Apt 1724, Charlotte, NC 28226-6015 2020-06-08
1922634484 Tracey Holton Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 2020-03-17
1710443395 Unity 4 Us Community Outreach Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 406 Lincoln St, Belmont, NC 28012-3045 2019-02-19
1871059444 Believing Everyone Succeeds Together Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 323 Shady Grove Rd, Kings Mtn, NC 28086-9671 2019-02-19
1740744283 Tri Plex Industries Corp Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 9635 Southern Pine Blvd Ste 154, Charlotte, NC 28273-5564 2019-01-29
1316415037 Igr Collaborations Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 212 Pine Ridge Dr, Roanoke Rapids, NC 27870-6832 2018-11-12
1164924940 David Douglas Whitfield Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5342 Us Highway 301 North, Micro, NC 27555 2018-03-07
1710489976 Moravian Enterprises, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 122 North Elm St., Suite 810, Greensboro, NC 27401 2018-03-05
1659897833 Shelby Day Program Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 621 S Dekalb St Ste A, Shelby, NC 28150-6189 2017-08-18
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Competitor

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City CLAYTON
Zip Code 27520

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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