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General NPI Number Information
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NPI Number | 1518467190
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Entity Type | Organization
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Legal Business Name | RAINBOW RESIDENTIALS
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 193 EAST AVE STE 103
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City | TALLMADGE
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State | OH
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Zip | 44278-2341
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Country | US
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Telephone | 330-819-4202
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Fax | 330-961-9909
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Provider Business Mailing Address
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Address Line | 193 EAST AVE STE 103
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City | TALLMADGE
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State | OH
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Zip | 44278-2341
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Country | US
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Telephone | 330-819-4202
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Fax | 330-961-9909
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANGELA D PARNELL-JACKSON
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Credential |
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Telephone | 330-819-3130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | OH
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