Organization
PENIEL INTERVENTIONAL CARE
Active
Other names
Peniel Health Services, PENIEL INTERVENTIONAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
ELSIE ANTWIWAA TWENEBOAH-KODUAH FNP-BC (OWNER)
(317) 797-9816
Entity
Organization
Contact information
Practice address
318 SPRY ISLAND RD, JOPPA, MD 21085-5424
(317) 797-9816
Mailing address
318 SPRY ISLAND RD, JOPPA, MD 21085-5424
(113) 177-9798
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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