Provider Demographics
NPI:1184816555
Name:REHOBOTH CONSULTING AGENCY
Entity Type:Organization
Organization Name:REHOBOTH CONSULTING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-231-3352
Mailing Address - Street 1:PO BOX 14449
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27620-4449
Mailing Address - Country:US
Mailing Address - Phone:919-834-2604
Mailing Address - Fax:919-834-2607
Practice Address - Street 1:2501 POOLE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2819
Practice Address - Country:US
Practice Address - Phone:919-834-2604
Practice Address - Fax:919-834-2607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health