# PETRA HOME CARE LLC

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

## Provider details

- **NPI number:** 1972119568
- **Authorized official:** VICTORIA A SHOWUNMI RN (ADMINISTRATOR)
- **Authorized official phone:** (631) 741-0795

## Contact information

- **Practice address:** 4518 KNIGHT LAKE CT, RICHMOND, TX 77406-7982
- **Practice address phone:** (281) 942-2670
- **Mailing address:** 4518 KNIGHT LAKE CT, RICHMOND, TX 77406-7982
- **Mailing address phone:** (281) 942-2670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/18/2020
- **Last updated:** 09/18/2020