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General NPI Number Information
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NPI Number | 1043400443
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Entity Type | Organization
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Legal Business Name | BENEVOLENT HEALTHCARE AGENCY
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 8535 FERNDALE RD SUITE 8
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City | DALLAS
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State | TX
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Zip | 75238-4425
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Country | US
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Telephone | 888-815-1705
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Fax | 469-443-0147
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Provider Business Mailing Address
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Address Line | PO BOX 860523
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City | PLANO
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State | TX
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Zip | 75086-0523
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Country | US
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Telephone | 888-815-1705
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Fax | 469-443-0147
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Authorized Official
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Title or Position | AGENCY ADMINISTRATOR
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Name | EVELYN MITCHELL
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Credential | M.ED
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Telephone | 888-815-1705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010965
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License Number State | TX
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