Organization
REHOBOTH HOME SUPPORT, LLC
Active
Organization
REHOBOTH HOME SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWIT G MEDHIN (DIRECTOR)
(303) 885-0183
Entity
Organization
Contact information
Practice address
12354 E CALEY AVE UNIT 201, CENTENNIAL, CO 80111-6853
(720) 524-7820
(720) 440-9154
Mailing address
12354 E CALEY AVE UNIT 201, CENTENNIAL, CO 80111-6853
(720) 524-7820
(720) 440-9154
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
CO
347E00000X
Transportation Broker
—
CO
376J00000X
Homemaker
—
—
Other
Enumeration date
04/02/2018
Last updated
10/22/2021
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