NPI Code Details Logo

NPI 1699652156

NPI 1699652156 : REHOBOTH LLC : MARICOPA, AZ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1699652156
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    REHOBOTH LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/18/2025
-----------------------------------------------------
    Last Update Date     |    08/18/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    16693 N LUNA DR 
-----------------------------------------------------
    City                 |    MARICOPA
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85138-2147
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    480-603-5286
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    43014 W WILD HORSE TRL 
-----------------------------------------------------
    City                 |    MARICOPA
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85138-8274
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    480-603-5286
-----------------------------------------------------
    Fax                  |    520-200-0057
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     JOY  TALABI 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    480-603-5286
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251S00000X
-----------------------------------------------------
    Taxonomy Name        |    Community/Behavioral Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.