Provider Demographics
NPI:1275368664
Name:PENDA HOME CARE LLC
Entity type:Organization
Organization Name:PENDA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MADOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-698-9281
Mailing Address - Street 1:1025 BURNHAM DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-7208
Mailing Address - Country:US
Mailing Address - Phone:925-698-9281
Mailing Address - Fax:520-423-3381
Practice Address - Street 1:40968 W PORTIS DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-4569
Practice Address - Country:US
Practice Address - Phone:520-457-7645
Practice Address - Fax:520-423-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility