Provider Demographics
NPI:1881371474
Name:REHOBOTH HEALTH CARE LLC
Entity type:Organization
Organization Name:REHOBOTH HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AWA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODIHI
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING, BSN, RN
Authorized Official - Phone:240-595-7030
Mailing Address - Street 1:7820 MAPLE RUN CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8667
Mailing Address - Country:US
Mailing Address - Phone:240-595-7030
Mailing Address - Fax:
Practice Address - Street 1:7820 MAPLE RUN CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8667
Practice Address - Country:US
Practice Address - Phone:240-595-7030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty