Provider Demographics
NPI:1942068697
Name:BENAB HEALTHCARE SERVICES INCORPORATED
Entity Type:Organization
Organization Name:BENAB HEALTHCARE SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHINEDUM
Authorized Official - Middle Name:L
Authorized Official - Last Name:ABANOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-476-9029
Mailing Address - Street 1:23118 TIMBER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4019
Mailing Address - Country:US
Mailing Address - Phone:240-476-9029
Mailing Address - Fax:
Practice Address - Street 1:23118 TIMBER CREEK LN
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4019
Practice Address - Country:US
Practice Address - Phone:240-476-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health