Provider Demographics
NPI:1114805165
Name:BENJAMIN COMMUNITY HEALTH CENTER INC
Entity type:Organization
Organization Name:BENJAMIN COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ILNISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-251-0267
Mailing Address - Street 1:3939 HOLLYWOOD BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6749
Mailing Address - Country:US
Mailing Address - Phone:954-251-0267
Mailing Address - Fax:954-239-7987
Practice Address - Street 1:3939 HOLLYWOOD BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6749
Practice Address - Country:US
Practice Address - Phone:954-251-0267
Practice Address - Fax:954-239-7987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty