Provider Demographics
NPI:1215359062
Name:RAINBOW LLC
Entity Type:Organization
Organization Name:RAINBOW LLC
Other - Org Name:RAINBOW HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-745-0033
Mailing Address - Street 1:870 FAIRVIEW AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4911
Mailing Address - Country:US
Mailing Address - Phone:270-745-0033
Mailing Address - Fax:
Practice Address - Street 1:870 FAIRVIEW AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4911
Practice Address - Country:US
Practice Address - Phone:270-745-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500172253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18-7188OtherMEDICARE CMS CERTIFICATION NUMBER