Provider Demographics
NPI:1508377755
Name:AMERICAN BENISON CLEANING
Entity Type:Organization
Organization Name:AMERICAN BENISON CLEANING
Other - Org Name:AMERICAN BENISON CLEANING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHONTAE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-625-6300
Mailing Address - Street 1:13212 TERMINAL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-4814
Mailing Address - Country:US
Mailing Address - Phone:440-625-6300
Mailing Address - Fax:
Practice Address - Street 1:13212 TERMINAL AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-4814
Practice Address - Country:US
Practice Address - Phone:440-625-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health