Rehoboth Home Support, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

REHOBOTH HOME SUPPORT, LLC

Practice address

12354 E Caley Ave Unit 201
Centennial, CO 80111-6853

Phone

(720) 524-7820

Fax

(720) 440-9154

NPI assigned

Apr 2, 2018

Organization subpart

No

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

Authorized official

Name

Dawit G Medhin

Title

Director

Phone

(303) 885-0183

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1881190791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12354 E CALEY AVE UNIT 201",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116853",
            "telephone_number": "720-524-7820",
            "fax_number": "720-440-9154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12354 E CALEY AVE UNIT 201",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116853",
            "telephone_number": "720-524-7820",
            "fax_number": "720-440-9154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHOBOTH HOME SUPPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "MEDHIN",
        "authorized_official_first_name": "DAWIT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-885-0183"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rehobothhomesupport@comcast.net",
            "affiliation": "N",
            "address_1": "12354 E Caley Ave Unit 201",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801116853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Reed
• Abigail Reeves
• Vesla Regan
• Rehabilitation Pathways Inc
• Rebecca Rehn
• Marilyn Reich, MOT, OTR/L
• Leslie A. Reichert, R.PH.
• Nicole Honnen Reid, MA, LPCC
• Maryjane Reilly
• Megan Reilly, DPT

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Centennial, CO
• Providers in Centennial, CO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.