Provider Demographics
NPI:1942048103
Name:REHOVOT SUPPORT SERVICES INCORPORATED
Entity type:Organization
Organization Name:REHOVOT SUPPORT SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOLASADE
Authorized Official - Middle Name:LARA
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-834-0476
Mailing Address - Street 1:50 HAMLET DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5427
Mailing Address - Country:US
Mailing Address - Phone:443-834-0476
Mailing Address - Fax:
Practice Address - Street 1:50 HAMLET DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5427
Practice Address - Country:US
Practice Address - Phone:443-834-0476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care