Organization
MG BENNON CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN MGBOLU (OWNER/ADMINISTRATOR)
(469) 354-8389
Entity
Organization
Contact information
Practice address
203 MILLSTONE DR, WYLIE, TX 75098-4743
(469) 354-8389
Mailing address
203 MILLSTONE DR, WYLIE, TX 75098-4743
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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