MEDICARE: RHEMA HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1811519705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHEMA HOME

Provider Business Mailing Address
First Line	:	PO BOX 86537
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85754-6537
Country	:	US
Telephone Number	:	520-721-1887
Fax Number	:	520-721-0069

Provider Business Practice Location Address
First Line	:	5959 S ROWAN CT
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-0005
Country	:	US
Telephone Number	:	520-369-0945
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RUGAAMBWA KIBIZI
Credential	:
Telephone Number	:	520-369-0945

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	05/13/2020

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Directions to “RHEMA HOME ” Practice Location

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