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NPI Code Detail

MEDICARE: REHOBA MANOR CARE HOME, INC

MEDICARE: REHOBA MANOR CARE HOME, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1347C00000XPrivate Vehicle
2376G00000XNursing Home Administrator
3374U00000XHome Health Aide

General Provider Information

NPI Number : 1265386767
Entity Type Code : Organization
Provider Name (Legal Business Name) : REHOBA MANOR CARE HOME, INC
Provider Business Mailing Address
First Line : 4800 STATELINE RD W
Second Line :
City : SOUTHAVEN
State : MS
Zip : 38671-5241
Country : US
Telephone Number : 901-354-1806
Fax Number : 901-354-1862
Provider Business Practice Location Address
First Line : 3485 DENVER ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38127-5673
Country : US
Telephone Number : 901-354-1806
Fax Number : 901-354-1862
Authorized Official
Title or Position : OWNER / ADMINISTRATOR
Name : MRS. SUZANNE PLEASHETTE GARMON-DUKES
Credential : BS, MBA
Telephone Number : 901-359-9919
Provider Enumeration Date : 02/23/2026
Last Update Date : 02/24/2026

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Directions to “REHOBA MANOR CARE HOME, INC ” Practice Location

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