Provider Demographics
NPI:1720374119
Name:BENEVOLENCE FIRST, INC
Entity Type:Organization
Organization Name:BENEVOLENCE FIRST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SENAYA
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MSM, CSW
Authorized Official - Phone:414-461-8171
Mailing Address - Street 1:5626 N 91ST ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-2745
Mailing Address - Country:US
Mailing Address - Phone:414-461-8171
Mailing Address - Fax:414-461-8130
Practice Address - Street 1:5626 N 91ST ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-2745
Practice Address - Country:US
Practice Address - Phone:414-461-8171
Practice Address - Fax:414-461-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency