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General NPI Number Information
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NPI Number | 1679897821
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Entity Type | Organization
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Legal Business Name | RAINBOW FAMILY LIFE CENTER
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 804 S HAMILTON ST
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City | SAGINAW
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State | MI
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Zip | 48602-1516
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Country | US
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Telephone | 989-401-3035
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Fax | 989-401-3181
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Provider Business Mailing Address
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Address Line | 320 S WASHINGTON AVE
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City | SAGINAW
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State | MI
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Zip | 48607-1152
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Country | US
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Telephone | 989-754-9000
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Fax | 989-754-9079
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DEDREA LARRETTE CARTER
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Credential | LMSW
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Telephone | 989-401-3035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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