Provider Demographics
NPI:1346768686
Name:RAIN BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:RAIN BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LISSETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RMHI, CCMS
Authorized Official - Phone:862-754-7373
Mailing Address - Street 1:8228 LOST LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1532
Mailing Address - Country:US
Mailing Address - Phone:862-754-7373
Mailing Address - Fax:
Practice Address - Street 1:8228 LOST LAKE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1532
Practice Address - Country:US
Practice Address - Phone:862-754-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management