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General NPI Number Information
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NPI Number | 1508620774
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Entity Type | Organization
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Legal Business Name | REHEBOTH OF HOPE LLC
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 2495 BASELINE ROAD
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City | ROSEVILEE
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State | CA
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Zip | 95747
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Country | US
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Telephone | 913-548-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 OAK AVE
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City | ROSEVILLE
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State | CA
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Zip | 95747-9210
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Country | US
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Telephone | 913-548-2461
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Fax |
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Authorized Official
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Title or Position | QIDP
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Name | JOYCE W KINYUA
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Credential | RN
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Telephone | 913-548-2461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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