Healthcare Provider Details

I. General information

NPI: 1770491037
Provider Name (Legal Business Name): THE BROTHER BENNO FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 PRODUCTION AVE
OCEANSIDE CA
92058-1308
US

IV. Provider business mailing address

PO BOX 308
OCEANSIDE CA
92049-0308
US

V. Phone/Fax

Practice location:
  • Phone: 760-439-1244
  • Fax:
Mailing address:
  • Phone: 951-837-7470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: PAUL MCNAMARA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 760-443-6336