Healthcare Provider Details

I. General information

NPI: 1184548174
Provider Name (Legal Business Name): REHOBOTH TREATMENT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20363 SW CASSANDRA LN
BEAVERTON OR
97007-4188
US

IV. Provider business mailing address

21675 SW JAY ST
BEAVERTON OR
97003-7072
US

V. Phone/Fax

Practice location:
  • Phone: 510-227-4685
  • Fax:
Mailing address:
  • Phone: 510-227-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TSEHAY ZELEKE BEFIRDU
Title or Position: OWNER
Credential: DIRECTOR
Phone: 510-227-4685