Provider Demographics
NPI:1205845476
Name:REHOBOTH HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:REHOBOTH HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNDAY
Authorized Official - Middle Name:OLADIPUPO
Authorized Official - Last Name:OSO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-255-1070
Mailing Address - Street 1:8323 SOUTHWEST FREEWAY #455
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1609
Mailing Address - Country:US
Mailing Address - Phone:713-255-1070
Mailing Address - Fax:713-255-1074
Practice Address - Street 1:8323 SOUTHWEST FREEWAY
Practice Address - Street 2:STE 455
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1609
Practice Address - Country:US
Practice Address - Phone:713-255-1070
Practice Address - Fax:713-255-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010197251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679556Medicare Oscar/Certification