Healthcare Provider Details

I. General information

NPI: 1134934805
Provider Name (Legal Business Name): BENEVOLENCE HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 08/09/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 COW HORN RD
RICHLANDS NC
28574-8143
US

IV. Provider business mailing address

12002 PRAXIS WAY
CARY NC
27519-0030
US

V. Phone/Fax

Practice location:
  • Phone: 910-382-0195
  • Fax: 919-234-0848
Mailing address:
  • Phone: 910-382-0195
  • Fax: 919-234-0848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHERONA DE'NAE BROOKS
Title or Position: OWNER
Credential:
Phone: 910-382-0195