Healthcare Provider Details

I. General information

NPI: 1578378550
Provider Name (Legal Business Name): REHOBOTH HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 WESTFIELD ST STE 4
WEST SPRINGFIELD MA
01089-3807
US

IV. Provider business mailing address

1233 WESTFIELD ST
WEST SPRINGFIELD MA
01089-3806
US

V. Phone/Fax

Practice location:
  • Phone: 413-285-0287
  • Fax:
Mailing address:
  • Phone: 413-285-0287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GODFRED ANSAH
Title or Position: CEO
Credential:
Phone: 413-330-6797