Provider Demographics
NPI:1083904320
Name:RAINBOW ACRES
Entity Type:Organization
Organization Name:RAINBOW ACRES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-554-8430
Mailing Address - Street 1:2120 W RESERVATION LOOP RD
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-8408
Mailing Address - Country:US
Mailing Address - Phone:928-567-5231
Mailing Address - Fax:928-567-9059
Practice Address - Street 1:2120 W RESERVATION LOOP RD
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-8408
Practice Address - Country:US
Practice Address - Phone:928-567-5231
Practice Address - Fax:928-567-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL1870C310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility