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General NPI Number Information
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NPI Number | 1659191732
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Entity Type | Organization
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Legal Business Name | UNDER THE RAINBOW LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1515 S LINCOLN ST
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City | SHAWANO
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State | WI
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Zip | 54166-3428
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Country | US
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Telephone | 715-524-4006
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Fax | 715-524-5595
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Provider Business Mailing Address
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Address Line | 1515 S LINCOLN ST
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City | SHAWANO
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State | WI
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Zip | 54166-3428
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Country | US
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Telephone | 715-524-4006
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Fax | 715-524-5595
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Authorized Official
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Title or Position | OWNER
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Name | MARY J MADSEN
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Credential |
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Telephone | 715-853-6944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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