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General NPI Number Information
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NPI Number | 1215634969
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Entity Type | Organization
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Legal Business Name | RAINBOW TRANSIT LLC
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 299 WOODSTREAM BLVD
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City | STAFFORD
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State | VA
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Zip | 22556-4632
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Country | US
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Telephone | 703-598-8620
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Fax |
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Provider Business Mailing Address
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Address Line | 299 WOODSTREAM BLVD
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City | STAFFORD
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State | VA
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Zip | 22556-4632
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Country | US
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Telephone | 703-589-8620
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CARLOTA HALL DE WILKS
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Credential |
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Telephone | 703-598-8620
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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