Organization
BENCURA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALTHA C SANDOVAL (CEO)
(855) 423-6287
Entity
Organization
Contact information
Practice address
125 TOWNPARK DR NW STE 300, KENNESAW, GA 30144-5812
(855) 423-6287
(678) 669-1562
Mailing address
125 TOWNPARK DR NW STE 300, KENNESAW, GA 30144-3231
(855) 423-6287
(678) 669-1562
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
GA
225X00000X
Occupational Therapist
—
GA
235Z00000X
Speech-Language Pathologist
—
GA
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
GA
Other
Enumeration date
04/12/2011
Last updated
03/03/2023
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