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1699900449

NPI Code Detail

MEDICARE: REBEKAH HOME HEALTHCARE, LLC

MEDICARE: REBEKAH HOME HEALTHCARE, LLC

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	261QH0100X	Health Service Clinic/Center	R2758P	MD
2	253Z00000X	In Home Supportive Care Agency	R2758P	MD
3	343800000X	Secured Medical Transport (VAN)	R2758P	MD
4	132700000X	Dietary Manager	R2758P	MD
5	133N00000X	Nutritionist	R2758P	MD
6	133NN1002X	Nutrition Education Nutritionist	R2758P	MD
7	146D00000X	Personal Emergency Response Attendant	R2758P	MD
8	164W00000X	Licensed Practical Nurse	R2758P	MD
9	163W00000X	Registered Nurse	R2758P	MD
10	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	R2758P	MD
11	163WA2000X	Administrator Registered Nurse	R2758P	MD
12	163WP2201X	Ambulatory Care Registered Nurse	R2758P	MD
13	163WC0400X	Case Management Registered Nurse	R2758P	MD
14	163WC1500X	Community Health Registered Nurse	R2758P	MD
15	251B00000X	Case Management Agency	R2758P	MD

General Provider Information

NPI Number	:	1699900449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBEKAH HOME HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	3829 KILBURN RD
Second Line	:	P.O.BOX 327
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-4655
Country	:	US
Telephone Number	:	410-922-2617
Fax Number	:	410-922-4620

Provider Business Practice Location Address
First Line	:	3829 KILBURN RD
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-4655
Country	:	US
Telephone Number	:	410-922-2617
Fax Number	:	410-922-4620

Authorized Official
Title or Position	:	PRESIDENT ,CEO, EX
Name	:	MRS. GLORIA LYNNE BROWN-BRISTOL
Credential	:
Telephone Number	:	410-922-2617

Provider Enumeration Date	:	05/22/2009
Last Update Date	:	11/30/2009

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Directions to “REBEKAH HOME HEALTHCARE, LLC ” Practice Location

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