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General NPI Number Information
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NPI Number | 1750585014
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Entity Type | Organization
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Legal Business Name | RAINBOW GARDENS ASSISTED LIVING FACILITY INC.
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1998 N.E. 178 ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 305-525-5466
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Fax | 305-825-2852
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Provider Business Mailing Address
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Address Line | 1998 N.E. 178 STREET
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 305-525-5466
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Fax | 305-825-2852
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MAYRA PEGUERO
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Credential |
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Telephone | 305-525-5466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL9155
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License Number State | FL
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