1801060793 NPI number — RAINBOW HOSPICE CORP.

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 1801060793 NPI number — RAINBOW HOSPICE CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAINBOW HOSPICE CORP.
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:
1801060793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2139 TAPO ST
Provider Second Line Business Mailing Address:
SUITE 213
Provider Business Mailing Address City Name:
SIMI VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93063-3478
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-526-0269
Provider Business Mailing Address Fax Number:
805-526-0521

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2139 TAPO ST
Provider Second Line Business Practice Location Address:
SUITE 213
Provider Business Practice Location Address City Name:
SIMI VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93063-3478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-526-0269
Provider Business Practice Location Address Fax Number:
805-526-0521
Provider Enumeration Date:
04/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ASUNCION
Authorized Official First Name:
ALFREDO
Authorized Official Middle Name:
PAZ
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
18055260269

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  550000554 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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