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General NPI Number Information
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NPI Number | 1295641306
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Entity Type | Organization
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Legal Business Name | BENEVOLENT CARE WELLNESS & TREATMENT CENTER LLC
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 6620 PARKDALE PL
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-5620
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Country | US
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Telephone | 317-712-6361
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Fax |
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Provider Business Mailing Address
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Address Line | 6602 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2865
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Country | US
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Telephone | 317-712-6361
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MIGNON R HOLDER
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Credential |
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Telephone | 317-712-6361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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