# PENIEL INTERVENTIONAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962234849
- **Authorized official:** ELSIE ANTWIWAA TWENEBOAH-KODUAH CRNP, CRNP-PMH (CO-OWNER)
- **Authorized official phone:** (667) 434-6218

## Contact information

- **Practice address:** 318 SPRY ISLAND RD, JOPPA, MD 21085-5424
- **Practice address phone:** (317) 797-9816
- **Mailing address:** 318 SPRY ISLAND RD, JOPPA, MD 21085-5424
- **Mailing address phone:** (317) 797-9816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2024
- **Last updated:** 08/19/2024