Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI Number | 1023728516 |
| LBN Legal business name | CENTRACARE HEALTH - BENSON LLC |
| Authorized official | MICHAEL BLAIR - (SR. VP/CFO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/25/2022 |
| Last updated | 01/25/2023 - About 3 years ago |
| Identifiers | n/a |
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