Provider Demographics
NPI:1043702608
Name:RAINBOW SERVICES LLC
Entity type:Organization
Organization Name:RAINBOW SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-532-5451
Mailing Address - Street 1:2940 N COURSE DR APT 501
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3814
Mailing Address - Country:US
Mailing Address - Phone:954-532-5451
Mailing Address - Fax:
Practice Address - Street 1:2940 N COURSE DR APT 501
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3814
Practice Address - Country:US
Practice Address - Phone:954-532-5451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233895253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL233895OtherAHCA