=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811874035
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAINBOW HOME HEALTH INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2025
-----------------------------------------------------
Last Update Date | 08/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4550 W OAKEY BLVD STE 111-W
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89102-1581
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-417-0271
-----------------------------------------------------
Fax | 205-896-0507
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4550 W OAKEY BLVD STE 111-W
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89102-1581
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-417-0271
-----------------------------------------------------
Fax | 205-896-0507
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SHEENFOL YSON BENITEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-524-0774
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------