Provider Demographics
NPI:1053852038
Name:BENA HOME CARE AGENCY INC
Entity Type:Organization
Organization Name:BENA HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BINROWTIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:ANGELINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-323-3053
Mailing Address - Street 1:12016 LIBERTY AVE FL 2
Mailing Address - Street 2:SOUTH RICHMOND HILL
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2118
Mailing Address - Country:US
Mailing Address - Phone:718-323-3053
Mailing Address - Fax:718-323-3052
Practice Address - Street 1:12016 LIBERTY AVE FL 2
Practice Address - Street 2:SOUTH RICHMOND HILL
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2118
Practice Address - Country:US
Practice Address - Phone:718-323-3053
Practice Address - Fax:718-323-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2429L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health