Organization Active NPI

Rehoboth Broad LLC

  • Developmentally Disabled Services Day Training Agency
  • Tolleson, AZ
National Provider Identifier
1063226454
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
REHOBOTH BROAD LLC
Doing business as
Rehoboth Broad llc
Practice address
5017 S 108TH Ave
Tolleson, AZ 85353-5779
Phone
(602) 748-9371
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Benita FurahaNPI 1427807684
Title
Owner
Phone
(602) 748-9371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU Primary
In Home Supportive Care Agency 253Z00000X NU

Addresses

Primary practice location

5017 S 108TH Ave
Tolleson, AZ 85353-5779

Mailing address

5017 S 108TH Ave
Tolleson, AZ 85353-5779

Other names 1

  • Rehoboth Broad llc Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1063226454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 S 108TH AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853535779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 S 108TH AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853535779",
            "telephone_number": "602-748-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHOBOTH BROAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "FURAHA",
        "authorized_official_first_name": "BENITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-748-9371"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehoboth Broad llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tolleson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.