Healthcare Provider Details

I. General information

NPI: 1396683876
Provider Name (Legal Business Name): NOLA NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 HOLLAND AVE
SENECA SC
29678-3600
US

IV. Provider business mailing address

315 HOLLAND AVE
SENECA SC
29678-3600
US

V. Phone/Fax

Practice location:
  • Phone: 864-900-4488
  • Fax: 864-900-4488
Mailing address:
  • Phone: 864-900-4488
  • Fax: 864-900-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. LEKESHA S BENSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 864-900-4488