Provider Demographics
NPI:1578378550
Name:REHOBOTH HOMECARE LLC
Entity type:Organization
Organization Name:REHOBOTH HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GODFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-330-6797
Mailing Address - Street 1:1233 WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3806
Mailing Address - Country:US
Mailing Address - Phone:413-285-0287
Mailing Address - Fax:
Practice Address - Street 1:1233 WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3806
Practice Address - Country:US
Practice Address - Phone:413-285-0287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-08
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility