Healthcare Provider Details

I. General information

NPI: 1538134499
Provider Name (Legal Business Name): RAINBOW HOSPICE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 W ROCKWELL ST
JEFFERSON WI
53549-2048
US

IV. Provider business mailing address

147 W ROCKWELL ST
JEFFERSON WI
53549-2048
US

V. Phone/Fax

Practice location:
  • Phone: 920-674-6255
  • Fax: 920-674-5288
Mailing address:
  • Phone: 920-674-6255
  • Fax: 920-674-5288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number508
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL R MAIER II
Title or Position: SECRETARY-TREASURER & CFO
Credential:
Phone: 920-674-6255