Provider Demographics
NPI: | 1326275769 |
---|---|
Name: | BENASIA HOUSE PROGRAMS |
Entity Type: | Organization |
Organization Name: | BENASIA HOUSE PROGRAMS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | FINANCE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | BRITTANY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MILES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 888-326-3213 |
Mailing Address - Street 1: | 7416 MARSHAND LN |
Mailing Address - Street 2: | APT 723 |
Mailing Address - City: | CHARLOTTE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28262 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 888-326-3213 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 106 GILMER ST |
Practice Address - Street 2: | |
Practice Address - City: | REIDSVILLE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27320-3870 |
Practice Address - Country: | US |
Practice Address - Phone: | 888-326-3213 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-06-12 |
Last Update Date: | 2009-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
No | 172A00000X | Other Service Providers | Driver | Group - Multi-Specialty | |
No | 221700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist | Group - Multi-Specialty | |
No | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | Group - Multi-Specialty | |
No | 225600000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Dance Therapist | Group - Multi-Specialty | |
No | 225A00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist | Group - Multi-Specialty | |
No | 247000000X | Technologists, Technicians & Other Technical Service Providers | Technician, Health Information | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 251X00000X | Agencies | Supports Brokerage | ||
No | 253Z00000X | Agencies | In Home Supportive Care | ||
No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service | |
No | 261QV0200X | Ambulatory Health Care Facilities | Clinic/Center | VA | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 347C00000X | Transportation Services | Private Vehicle | Group - Multi-Specialty |