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PENISTON PERSONAL CARE HOME,LLC
NPI 1003465626
Home Health in Fairburn, GA

Active since September 06, 2019
4680 SUNDRIDGE TRL, FAIRBURN, GA 30213(678) 545-3934(770) 892-1051 Get Directions Write a Review

NPPES record last updated: May 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2023, Sep 6, 2019 (2 updates tracked since 2019).

About Peniston Personal Care Home,llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENISTON PERSONAL CARE HOME,LLC (NPI 1003465626), doing business as Peniston Personal Care Home, Llc, is a healthcare organization registered as a home health in Fairburn, Georgia and active in the NPI registry since September 2019. The organization lists Breezy U Houston, Owner, as its authorized official.

NPPES Registry Identity

NPI1003465626
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NamePENISTON PERSONAL CARE HOME,LLC
Location Address4680 SUNDRIDGE TRLFairburn, GA 30213-1997
Mailing Address4680 Sundridge TrlFairburn, GA 30213-1997 · (678) 545-3934 · Fax (770) 892-1051
Phone(678) 545-3934
Fax(770) 892-1051
Organization SubpartNo
Authorized OfficialBreezy U HoustonOwner · (678) 545-3934
Enumeration DateSeptember 6, 2019
Last NPPES UpdateMay 18, 20232 updates tracked since enumeration
NPPES CertifiedMay 18, 2023
✔ NPI 1003465626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Also ListedRegistered Nurse · Home HealthTaxonomy 163WH0200X
Also ListedHome Health AideTaxonomy 374U00000X
4680 SUNDRIDGE TRL, Fairburn, GA 30213
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Other Names 1

Former Legal Business NamePeniston Personal Care Home, Llc

Other Identifiers 2

Medicaid003217267BGA
Medicaid003217267AGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PENISTON PERSONAL CARE HOME,LLC
Assisted Living Facility
4680 SUNDRIDGE TRL
FAIRBURN, GA 30213
Fulton County (678) 545-3934
BREEZY HOUSTON
Community/Behavioral Health
4680 SUNDRIDGE TRL
FAIRBURN, GA 30213
Fulton County (678) 545-3934

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peniston Personal Care Home,llc's NPI number?

The NPI number for Peniston Personal Care Home,llc is 1003465626. It was assigned to this organization in the NPPES registry on September 6, 2019. The provider was formerly known as Peniston Personal Care Home, LLC.

Where is Peniston Personal Care Home,llc located?

Peniston Personal Care Home,llc is located at 4680 Sundridge Trl, Fairburn, GA 30213. The listed phone number is (678) 545-3934.

What is Peniston Personal Care Home,llc's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

When was this NPI record last updated?

The NPPES record for Peniston Personal Care Home,llc was last updated on May 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.