MEDICARE: REBEL HEALTHCARE 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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1285583708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBEL HEALTHCARE INC

Provider Business Mailing Address
First Line	:	1000 E ARMY POST RD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50315-5939
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 E ARMY POST RD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50315-5939
Country	:	US
Telephone Number	:	712-223-0164
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. LORRAINE ROGE-JONES
Credential	:
Telephone Number	:	712-223-0164

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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