Provider Demographics
NPI:1437505427
Name:BENELLA ROSE ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:BENELLA ROSE ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAUNTAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-222-9073
Mailing Address - Street 1:7814 BLUE STREAM CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-1267
Mailing Address - Country:US
Mailing Address - Phone:281-222-9073
Mailing Address - Fax:832-201-6551
Practice Address - Street 1:7814 BLUE STREAM CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-1267
Practice Address - Country:US
Practice Address - Phone:281-222-9073
Practice Address - Fax:832-201-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care