=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154233757
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REBIRTH CARE AND SUPPORTS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2026
-----------------------------------------------------
Last Update Date | 09/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6423 CABELL CT
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22150-1326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-934-2600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6423 CABELL CT
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22150-1326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-934-2600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. GEORGE ETENGENENG AKOACHERE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 609-934-2600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------