Provider Demographics
NPI:1801196654
Name:REHOBOTH C& A THERAPY
Entity Type:Organization
Organization Name:REHOBOTH C& A THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANETHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-734-1006
Mailing Address - Street 1:608 W KING ST
Mailing Address - Street 2:SUITE C-D
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-3373
Mailing Address - Country:US
Mailing Address - Phone:704-734-1006
Mailing Address - Fax:704-734-1008
Practice Address - Street 1:608 W KING ST
Practice Address - Street 2:SUITE C-D
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3373
Practice Address - Country:US
Practice Address - Phone:704-734-1006
Practice Address - Fax:704-734-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health