1205439981 NPI number — RAINBOW REHABILITATION CENTERS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205439981 NPI number — RAINBOW REHABILITATION CENTERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAINBOW REHABILITATION CENTERS, 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:
1205439981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17187 N LAUREL PARK DR STE 160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48152-2692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-482-1200
Provider Business Mailing Address Fax Number:
734-482-3202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1435 AIRPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERFORD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48327-1809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-898-0926
Provider Business Practice Location Address Fax Number:
734-482-0494
Provider Enumeration Date:
11/17/2020

Additional Information

Authorized Official

Authorized Official Last Name:
FIFE
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
734-482-1200

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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