Healthcare Provider Details

I. General information

NPI: 1477155471
Provider Name (Legal Business Name): REBEKAH CALALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N JACKSON ST
SPENCER OH
44275-8501
US

IV. Provider business mailing address

PO BOX 263
SPENCER OH
44275-0263
US

V. Phone/Fax

Practice location:
  • Phone: 440-371-5422
  • Fax:
Mailing address:
  • Phone: 440-371-5422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: