Healthcare Provider Details

I. General information

NPI: 1427851583
Provider Name (Legal Business Name): BENCHMARK CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

892 PIN OAK DR
ANTIOCH TN
37013-1532
US

IV. Provider business mailing address

892 PIN OAK DR
ANTIOCH TN
37013-1532
US

V. Phone/Fax

Practice location:
  • Phone: 615-482-3379
  • Fax:
Mailing address:
  • Phone: 615-482-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: WINIFRED OTARU
Title or Position: OWNER/MEMBER
Credential:
Phone: 615-482-3379