Provider Demographics
NPI:1073849154
Name:REBEKAH HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:REBEKAH HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER CEO/ EXCUTIVE OFFER
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROWN- BRISTOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-922-2617
Mailing Address - Street 1:3829 KILBURN RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4655
Mailing Address - Country:US
Mailing Address - Phone:410-922-2617
Mailing Address - Fax:410-922-4620
Practice Address - Street 1:3829 KILBURN RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4655
Practice Address - Country:US
Practice Address - Phone:410-922-2617
Practice Address - Fax:410-922-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2800R163WR0400X, 163WS0200X, 163WU0100X, 163WW0000X, 163WW0101X, 332BD1200X, 347B00000X, 347C00000X, 372600000X, 374700000X, 3747A0650X, 374U00000X, 376J00000X, 376K00000X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Multi-Specialty
No163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Multi-Specialty
No163WU0100XNursing Service ProvidersRegistered NurseUrologyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Multi-Specialty
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & SuppliesGroup - Multi-Specialty
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374700000XNursing Service Related ProvidersTechnicianGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty