Healthcare Provider Details

I. General information

NPI: 1689840381
Provider Name (Legal Business Name): HELPING RAINBOW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 11/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 RUSHING RD
LAKELAND FL
33810-0738
US

IV. Provider business mailing address

PO BOX 91092
LAKELAND FL
33804-1092
US

V. Phone/Fax

Practice location:
  • Phone: 813-474-2437
  • Fax: 206-338-3962
Mailing address:
  • Phone: 813-474-2437
  • Fax: 206-338-3962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSE-MARIE PORTER
Title or Position: PROGRAM MANAGER
Credential:
Phone: 813-474-2437