Healthcare Provider Details
I. General information
NPI: 1629905542
Provider Name (Legal Business Name): BENEVOLENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1205 GRAND RIVER DR
SACRAMENTO CA
95831-4421
US
IV. Provider business mailing address
1205 GRAND RIVER DR
SACRAMENTO CA
95831-4421
US
V. Phone/Fax
- Phone: 916-228-4601
- Fax: 916-376-7659
- Phone: 916-228-4601
- Fax: 916-376-7659
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELAINE
TOLENTINO
Title or Position: OWNER AND ADMINISTRATOR
Credential:
Phone: 209-450-6530