Healthcare Provider Details

I. General information

NPI: 1265201743
Provider Name (Legal Business Name): REHOBOTH HOME CARE INC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 MASON RD APT 3303
RICHMOND TX
77406-0065
US

IV. Provider business mailing address

9900 MASON RD APT 3303
RICHMOND TX
77406-0065
US

V. Phone/Fax

Practice location:
  • Phone: 781-513-6632
  • Fax:
Mailing address:
  • Phone: 781-513-6632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: NEHLA NAMBOUH
Title or Position: ADMINISTRATOR
Credential:
Phone: 781-513-6632