Provider Demographics
NPI:1316775752
Name:PENALOSA INVESTIMENTS LLC
Entity type:Organization
Organization Name:PENALOSA INVESTIMENTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PENALOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:525-586-1847
Mailing Address - Street 1:4025 E SOUTHCROSS BLVD STE 28
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3640
Mailing Address - Country:US
Mailing Address - Phone:201-882-0630
Mailing Address - Fax:
Practice Address - Street 1:4025 E SOUTHCROSS BLVD STE 28
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3640
Practice Address - Country:US
Practice Address - Phone:201-882-0630
Practice Address - Fax:201-780-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty