Provider Demographics
NPI:1225604358
Name:BENEVOLENT CARE LLC
Entity Type:Organization
Organization Name:BENEVOLENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGISHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-344-7675
Mailing Address - Street 1:37 W DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6149
Mailing Address - Country:US
Mailing Address - Phone:207-344-7675
Mailing Address - Fax:
Practice Address - Street 1:37 W DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6149
Practice Address - Country:US
Practice Address - Phone:207-344-7675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty