Provider Demographics
NPI:1235676586
Name:SOMEWHERE OVER THE RAINBOW CENTER
Entity Type:Organization
Organization Name:SOMEWHERE OVER THE RAINBOW CENTER
Other - Org Name:SOMEWHERE OVER THE RAINBOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:NATARSHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-896-3859
Mailing Address - Street 1:2026 WILDWOOD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3068
Mailing Address - Country:US
Mailing Address - Phone:832-896-3859
Mailing Address - Fax:
Practice Address - Street 1:2026 WILDWOOD RIDGE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3068
Practice Address - Country:US
Practice Address - Phone:832-896-3859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health