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General NPI Number Information
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NPI Number | 1801279997
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Entity Type | Organization
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Legal Business Name | BENITA HOMECARE, INC.
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 2717 E 22ND ST
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City | AUSTIN
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State | TX
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Zip | 78722-1701
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Country | US
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Telephone | 512-580-2802
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Fax | 512-580-2803
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Provider Business Mailing Address
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Address Line | 2717 E 22ND ST
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City | AUSTIN
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State | TX
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Zip | 78722-1701
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Country | US
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Telephone | 512-580-2802
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Fax | 512-580-2803
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. BENITA TURK
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Credential |
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Telephone | 713-898-4311
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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 | 017304
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License Number State | TX
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