Provider Demographics
NPI:1164114963
Name:REHOBOTH HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:REHOBOTH HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:GBENGA
Authorized Official - Last Name:OLAOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-412-3237
Mailing Address - Street 1:5530 BAVERHOF DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-8312
Mailing Address - Country:US
Mailing Address - Phone:919-412-3237
Mailing Address - Fax:
Practice Address - Street 1:5530 BAVERHOF DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-8312
Practice Address - Country:US
Practice Address - Phone:919-412-3237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care