Provider Demographics
NPI:1245565779
Name:BENU HEALTH CARE SERVICES,LLC
Entity Type:Organization
Organization Name:BENU HEALTH CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:NCHOTAKU
Authorized Official - Last Name:FORKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-353-9096
Mailing Address - Street 1:6495 NEW HAMPSHIRE AVE STE LL033
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3299
Mailing Address - Country:US
Mailing Address - Phone:240-353-9096
Mailing Address - Fax:301-446-3562
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE STE LL033
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3299
Practice Address - Country:US
Practice Address - Phone:240-353-9096
Practice Address - Fax:301-446-3562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances