Provider Demographics
NPI:1255755849
Name:BENRAC TENDER CARE INC
Entity type:Organization
Organization Name:BENRAC TENDER CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MOJOYIN
Authorized Official - Last Name:ALEGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-760-0980
Mailing Address - Street 1:910 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4148
Mailing Address - Country:US
Mailing Address - Phone:813-760-0980
Mailing Address - Fax:
Practice Address - Street 1:910 BRIARCLIFF DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-4148
Practice Address - Country:US
Practice Address - Phone:813-760-0980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005924700Medicaid