Provider Demographics
NPI:1295535060
Name:PETRA HOME HEALTH AND HOSPICE SERVICES
Entity type:Organization
Organization Name:PETRA HOME HEALTH AND HOSPICE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHOWUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:631-741-0795
Mailing Address - Street 1:4518 KNIGHT LAKE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7982
Mailing Address - Country:US
Mailing Address - Phone:713-320-9619
Mailing Address - Fax:713-513-5279
Practice Address - Street 1:4518 KNIGHT LAKE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7982
Practice Address - Country:US
Practice Address - Phone:713-320-9619
Practice Address - Fax:713-513-5279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based