Provider Demographics
NPI:1831661529
Name:BENEVOLENCE INDUSTRIES INC.
Entity Type:Organization
Organization Name:BENEVOLENCE INDUSTRIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KWABENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-734-1600
Mailing Address - Street 1:1010 CRENSHAW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2055
Mailing Address - Country:US
Mailing Address - Phone:310-617-5651
Mailing Address - Fax:424-558-8100
Practice Address - Street 1:12610 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4783
Practice Address - Country:US
Practice Address - Phone:818-361-4111
Practice Address - Fax:818-361-7584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty