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General NPI Number Information
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NPI Number | 1518365386
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Entity Type | Organization
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Legal Business Name | REHEMA HOMECARE
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 12236 N 49TH DR
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City | GLENDALE
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State | AZ
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Zip | 85304-2214
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Country | US
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Telephone | 623-755-4931
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Fax | 602-843-3473
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Provider Business Mailing Address
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Address Line | 12236 N 49TH DR
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City | GLENDALE
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State | AZ
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Zip | 85304-2214
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Country | US
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Telephone | 623-755-4931
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Fax | 602-843-3473
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ZEITUNI JELAGAT KIPROTICH
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Credential |
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Telephone | 623-755-4931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH4511
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License Number State | AZ
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