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General NPI Number Information
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NPI Number | 1952845935
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Entity Type | Organization
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Legal Business Name | RAINBOW CENTERS
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 12501 HAMILTON AVE
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City | HIGHLAND PARK
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State | MI
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Zip | 48203-3243
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Country | US
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Telephone | 313-865-1580
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Fax | 313-865-1582
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Provider Business Mailing Address
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Address Line | 102 BRIGHTON ST
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City | HIGHLAND PARK
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State | MI
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Zip | 48203-2537
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Country | US
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Telephone | 313-401-6858
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | DEBORAH ANN SCOTT
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Credential |
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Telephone | 313-401-6858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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