Provider Demographics
NPI:1093251928
Name:WIHELMENA CARE CENTER
Entity type:Organization
Organization Name:WIHELMENA CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MBA/HCM
Authorized Official - Phone:832-621-9359
Mailing Address - Street 1:5301 BRETT DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1236
Mailing Address - Country:US
Mailing Address - Phone:832-621-9359
Mailing Address - Fax:
Practice Address - Street 1:9502 ROSEHAVEN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-3131
Practice Address - Country:US
Practice Address - Phone:832-621-9359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHANNEL OF HOPE OUTREACH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666663261QA0600X, 261QH0100X, 311500000X, 311Z00000X, 311ZA0620X, 313M00000X, 332B00000X, 332BN1400X, 332BX2000X, 3416L0300X, 343800000X, 343900000X, 385H00000X, 385HR2060X, 3104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child