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General NPI Number Information
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NPI Number | 1568737096
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Entity Type | Individual
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Provider Name | ARLES ARISTEO BENAVIDES B.A.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2012
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 147 S 6TH AVE SPIRITT FAMILY SERVICES, LA PUENTE CENTER
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City | LA PUENTE
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State | CA
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Zip | 91746-2914
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Country | US
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Telephone | 626-968-0791
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Fax | 626-968-9892
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Provider Business Mailing Address
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Address Line | 13710 MARQUITA LN
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City | WHITTIER
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State | CA
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Zip | 90604-4373
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Country | US
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Telephone | 562-972-1265
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Fax | 626-968-9892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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