Provider Demographics
NPI:1063192144
Name:BENEVOLENT CARE HOME HEALTH
Entity type:Organization
Organization Name:BENEVOLENT CARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWTHORNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:502-594-2640
Mailing Address - Street 1:927 FRENCH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-4100
Mailing Address - Country:US
Mailing Address - Phone:502-594-2640
Mailing Address - Fax:
Practice Address - Street 1:927 FRENCH ST APT 1
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-4100
Practice Address - Country:US
Practice Address - Phone:502-594-2640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health