Healthcare Provider Details

I. General information

NPI: 1801227582
Provider Name (Legal Business Name): REHOBOTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 NEW YORK AVE
BROOKLYN NY
11203-1507
US

IV. Provider business mailing address

598 NEW YORK AVE
BROOKLYN NY
11203-1507
US

V. Phone/Fax

Practice location:
  • Phone: 347-221-1646
  • Fax: 347-305-3322
Mailing address:
  • Phone: 347-221-1646
  • Fax: 347-305-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. ADEDOLAPO OLURINDE
Title or Position: CEO
Credential: DPT
Phone: 347-221-1646