MEDICARE: BENEGENT HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1790562056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENEGENT HEALTH

Provider Business Mailing Address
First Line	:	10601 N 39TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3417
Country	:	US
Telephone Number	:	602-290-2684
Fax Number	:

Provider Business Practice Location Address
First Line	:	10601 N 39TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3417
Country	:	US
Telephone Number	:	602-290-2684
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. DEBORAH LILLIAS WOODARD
Credential	:	MSW
Telephone Number	:	602-290-2684

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	09/11/2023

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Directions to “BENEGENT HEALTH ” Practice Location

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