Provider Demographics
NPI:1104538446
Name:REHOBOTH HEALTHCARE LLC
Entity type:Organization
Organization Name:REHOBOTH HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISI
Authorized Official - Middle Name:
Authorized Official - Last Name:IGIEBOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-203-2949
Mailing Address - Street 1:27 LARK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08882-2605
Mailing Address - Country:US
Mailing Address - Phone:848-203-2949
Mailing Address - Fax:
Practice Address - Street 1:27 LARK DR
Practice Address - Street 2:
Practice Address - City:SOUTH RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08882-2605
Practice Address - Country:US
Practice Address - Phone:848-203-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty