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General NPI Number Information
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NPI Number | 1245565779
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Entity Type | Organization
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Legal Business Name | BENU HEALTH CARE SERVICES,LLC
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 6495 NEW HAMPSHIRE AVE STE LL033
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City | HYATTSVILLE
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State | MD
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Zip | 20783-3299
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Country | US
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Telephone | 240-353-9096
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Fax | 301-446-3562
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Provider Business Mailing Address
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Address Line | 6495 NEW HAMPSHIRE AVE STE LL033
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City | HYATTSVILLE
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State | MD
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Zip | 20783-3299
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Country | US
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Telephone | 240-353-9096
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Fax | 301-446-3562
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Authorized Official
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Title or Position | CEO
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Name | MR. NICHOLAS NCHOTAKU FORKA
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Credential |
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Telephone | 240-353-9096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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