1609303932 NPI number — RAINBOW HOME HEALTHCARE INC

Table of content: (NPI 1609303932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609303932 NPI number — RAINBOW HOME HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAINBOW HOME HEALTHCARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609303932
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2035 COUNTY ROAD D E STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAPLEWOOD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55109-5301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-778-0562
Provider Business Mailing Address Fax Number:
651-778-9967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2035 COUNTY ROAD D E STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAPLEWOOD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55109-5301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-778-0562
Provider Business Practice Location Address Fax Number:
651-778-9967
Provider Enumeration Date:
05/17/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOR
Authorized Official First Name:
LAUVUATAW
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
651-778-0562

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A455433300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: M328678000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 69239 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 170909 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: A073455100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".