Healthcare Provider Details

I. General information

NPI: 1154233757
Provider Name (Legal Business Name): REBIRTH CARE AND SUPPORTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6423 CABELL CT
SPRINGFIELD VA
22150-1326
US

IV. Provider business mailing address

6423 CABELL CT
SPRINGFIELD VA
22150-1326
US

V. Phone/Fax

Practice location:
  • Phone: 609-934-2600
  • Fax:
Mailing address:
  • Phone: 609-934-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE ETENGENENG AKOACHERE
Title or Position: CEO
Credential:
Phone: 609-934-2600