Provider Demographics
NPI:1134968985
Name:REHOBOTH WELLNESS CENTER
Entity type:Organization
Organization Name:REHOBOTH WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIBUZO
Authorized Official - Middle Name:
Authorized Official - Last Name:EFURIBE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,FNP, PMHNP
Authorized Official - Phone:240-486-2007
Mailing Address - Street 1:1942 MUSTANG BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5792
Mailing Address - Country:US
Mailing Address - Phone:240-486-2007
Mailing Address - Fax:
Practice Address - Street 1:17030 NANES DR STE 209
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2533
Practice Address - Country:US
Practice Address - Phone:240-486-2007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care