Individual
MR. RONALD ANTHONY BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1594 CANDACE RIDGE DR, GREENSBORO, NC 27406-8595
(336) 558-1742
Mailing address
1594 CANDACE RIDGE DR, GREENSBORO, NC 27406-8595
(336) 558-1742
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
83-0571854
NC
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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