Provider Demographics
NPI:1013641471
Name:RAINBOW FLAME COLLABORATIVE
Entity Type:Organization
Organization Name:RAINBOW FLAME COLLABORATIVE
Other - Org Name:INTO THE GREY BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:SPENSER-NICHOLAS
Authorized Official - Last Name:GREY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-365-4497
Mailing Address - Street 1:4845 PEARL EAST CIR STE 118
Mailing Address - Street 2:PMB 68698
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-6112
Mailing Address - Country:US
Mailing Address - Phone:720-365-4497
Mailing Address - Fax:
Practice Address - Street 1:4845 PEARL EAST CIR STE 118
Practice Address - Street 2:PMB 68698
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-6112
Practice Address - Country:US
Practice Address - Phone:720-365-4497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty