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General NPI Number Information
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NPI Number | 1578708483
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Entity Type | Organization
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Legal Business Name | RAINBOW PEDIATRIC HOME HEALTH PLLC
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Dates
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Enumeration Date | 12/05/2008
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 4211 GARDENDALE SUITE A201
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-362-4622
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Fax | 210-615-7848
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Provider Business Mailing Address
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Address Line | 4211 GARDENDALE SUITE A201
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-362-4622
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Fax | 210-615-7848
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ROSE A. HYDEN
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Credential |
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Telephone | 210-362-4622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 28115649A
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License Number State | TX
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