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General NPI Number Information
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NPI Number | 1043702608
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Entity Type | Organization
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Legal Business Name | RAINBOW SERVICES LLC
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 2940 N COURSE DR APT 501
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3814
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Country | US
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Telephone | 954-532-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 2940 N COURSE DR APT 501
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3814
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Country | US
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Telephone | 954-532-5451
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | STEWART ALLEN PEPPER
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Credential |
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Telephone | 954-532-5451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 233895
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License Number State | FL
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