Provider Demographics
NPI:1699383729
Name:BENEVOLENT HOME AND HEALTH LLC
Entity Type:Organization
Organization Name:BENEVOLENT HOME AND HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DREAMELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FURGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:404-353-4385
Mailing Address - Street 1:290 MLK JR DR SE UNIT 4409
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 MLK JR DR SE UNIT 4409
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2540
Practice Address - Country:US
Practice Address - Phone:404-353-4385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health