Organization
REHOBOTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOY TALABI (ADMINISTRATOR)
(480) 603-5286
Entity
Organization
Contact information
Practice address
19436 N SMITH DR, MARICOPA, AZ 85139-6877
(480) 603-5286
Mailing address
43014 W WILD HORSE TRL, MARICOPA, AZ 85138-8274
(480) 603-5286
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
BH4563
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH4563
AZ
323P00000X
Psychiatric Residential Treatment Facility
BH4563
AZ
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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