Provider Demographics
NPI:1972045045
Name:REHOBOTH RESOURCES CARE, LLC
Entity Type:Organization
Organization Name:REHOBOTH RESOURCES CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:C
Authorized Official - Last Name:OZOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7202-578-2924
Mailing Address - Street 1:4734 FLANDERS WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6727
Mailing Address - Country:US
Mailing Address - Phone:720-257-2924
Mailing Address - Fax:303-371-0524
Practice Address - Street 1:4734 FLANDERS WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6727
Practice Address - Country:US
Practice Address - Phone:720-257-2924
Practice Address - Fax:303-371-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care