# BENITAZ INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Benitaz Homecare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245942119
- **Authorized official:** MR. BENJAMIN OBI (DIRECTOR)
- **Authorized official phone:** (719) 209-8200

## Contact information

- **Practice address:** 115 SWILCAN DR, FAYETTEVILLE, GA 30215-7815
- **Practice address phone:** (720) 885-3959
- **Mailing address:** 115 SWILCAN DR, FAYETTEVILLE, GA 30215-7815
- **Mailing address phone:** (719) 209-8200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/22/2022
- **Last updated:** 05/12/2023