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General NPI Number Information
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NPI Number | 1134934805
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Entity Type | Organization
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Legal Business Name | BENEVOLENCE HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 08/24/2025
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Provider Practice Location Address
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Address Line | 5114 WESTERN BLVD APT 1313
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City | JACKSONVILLE
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State | NC
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Zip | 28546-0034
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Country | US
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Telephone | 910-382-0195
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Fax | 910-238-4152
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Provider Business Mailing Address
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Address Line | 5114 WESTERN BLVD APT 1313
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City | JACKSONVILLE
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State | NC
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Zip | 28546-0034
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Country | US
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Telephone | 910-382-0195
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Fax | 910-238-4152
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Authorized Official
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Title or Position | OWNER
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Name | SHERONA DE'NAE BROOKS
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Credential |
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Telephone | 910-382-0195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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