MEDICARE: BENITA HOMECARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1679950331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENITA HOMECARE, INC

Provider Business Mailing Address
First Line	:	1602 HAZEL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-1108
Country	:	US
Telephone Number	:	713-898-4311
Fax Number	:	713-944-4224

Provider Business Practice Location Address
First Line	:	1602 HAZEL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-1108
Country	:	US
Telephone Number	:	713-898-4311
Fax Number	:	713-944-4224

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. BENITA TURK
Credential	:
Telephone Number	:	713-898-4311

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	05/01/2015

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