Provider Demographics
NPI:1376264333
Name:REHOBOTHHEALTHCARE LLC
Entity Type:Organization
Organization Name:REHOBOTHHEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:TOYIN
Authorized Official - Middle Name:OLUYEMISI
Authorized Official - Last Name:AKINWALE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:850-567-0031
Mailing Address - Street 1:5650 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1249
Mailing Address - Country:US
Mailing Address - Phone:972-464-6352
Mailing Address - Fax:
Practice Address - Street 1:5650 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-1249
Practice Address - Country:US
Practice Address - Phone:972-464-6352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health