Healthcare Provider Details

I. General information

NPI: 1497942551
Provider Name (Legal Business Name): OPERATION RAINBOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 55 COUNTY RD V-3
MANTER KS
67862-9411
US

IV. Provider business mailing address

HC 1 BOX 55 COUNTY RD V-3
MANTER KS
67862-9411
US

V. Phone/Fax

Practice location:
  • Phone: 620-592-2061
  • Fax: 620-592-2061
Mailing address:
  • Phone: 620-592-2061
  • Fax: 620-592-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number200428600A
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number200428600A
License Number StateKS

VIII. Authorized Official

Name: CHRIS FROWNFELTER
Title or Position: OWNER
Credential:
Phone: 620-592-2061