Provider Demographics
NPI:1245682921
Name:BENEVOLENCE INDUSTRIES INCORPORATED
Entity type:Organization
Organization Name:BENEVOLENCE INDUSTRIES INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
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:323-732-0100
Mailing Address - Street 1:1010 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2056
Mailing Address - Country:US
Mailing Address - Phone:323-732-0100
Mailing Address - Fax:424-558-8100
Practice Address - Street 1:515 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0007
Practice Address - Country:US
Practice Address - Phone:323-732-0100
Practice Address - Fax:424-558-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health