Provider Demographics
NPI:1043835697
Name:REHOBOTH TEXAS CORPORATION
Entity Type:Organization
Organization Name:REHOBOTH TEXAS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAIWO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-323-9560
Mailing Address - Street 1:10903 COLDWATER BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-0945
Mailing Address - Country:US
Mailing Address - Phone:281-323-9560
Mailing Address - Fax:
Practice Address - Street 1:10903 COLDWATER BRIDGE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-0945
Practice Address - Country:US
Practice Address - Phone:281-323-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral CareGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home