MEDICARE: RAINBOW HOME CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1548854631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAINBOW HOME CARE INC

Provider Business Mailing Address
First Line	:	13760 NOEL RD STE 345
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-7336
Country	:	US
Telephone Number	:	720-260-2904
Fax Number	:

Provider Business Practice Location Address
First Line	:	13760 NOEL RD STE 345
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-7336
Country	:	US
Telephone Number	:	720-260-2904
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	H. RAY PRIEST
Credential	:
Telephone Number	:	720-260-2904

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	03/01/2021

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