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General NPI Number Information
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NPI Number | 1598488447
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Entity Type | Organization
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Legal Business Name | REHOBOTH HOMES LLC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 828 S REBER AVE
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City | GILBERT
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State | AZ
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Zip | 85296-1467
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Country | US
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Telephone | 602-578-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 3324 E RAY RD UNIT 517
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City | HIGLEY
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State | AZ
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Zip | 85236-4525
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Country | US
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Telephone | 602-578-5445
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. OLUWATOFUNMI FAKOYA
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Credential |
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Telephone | 602-578-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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