Provider Demographics
NPI:1255151387
Name:BEN HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BEN HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED ZACCHEUS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-234-6433
Mailing Address - Street 1:9800 NORTHWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1857
Mailing Address - Country:US
Mailing Address - Phone:763-221-0167
Mailing Address - Fax:763-600-6102
Practice Address - Street 1:9800 NORTHWOOD AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1857
Practice Address - Country:US
Practice Address - Phone:763-221-0167
Practice Address - Fax:763-600-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty