1639358633 NPI number — RAINBOW RECOVERY CENTER, INC.

Table of content: (NPI 1639358633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639358633 NPI number — RAINBOW RECOVERY CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAINBOW RECOVERY CENTER, 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:
1639358633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
912 E STATE ST STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHARON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16146-3361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-269-5130
Provider Business Mailing Address Fax Number:
724-269-5095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
912 E STATE ST STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16146-3361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-269-5130
Provider Business Practice Location Address Fax Number:
724-269-5095
Provider Enumeration Date:
10/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINOWITZ
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-269-5130

Provider Taxonomy Codes

  • Taxonomy code: 261QM2800X , with the licence number:  437027 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 437027 . This is a "FACILITY LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com