Provider Demographics
NPI:1508634627
Name:THE RAINBOW CIRCLES NUTRITION, LLC
Entity Type:Organization
Organization Name:THE RAINBOW CIRCLES NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE/ADMINISTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA-LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:360-550-2840
Mailing Address - Street 1:2850 MCCLELLAND DR STE 3600
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2587
Mailing Address - Country:US
Mailing Address - Phone:970-900-6179
Mailing Address - Fax:
Practice Address - Street 1:2850 MCCLELLAND DR STE 3600
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2587
Practice Address - Country:US
Practice Address - Phone:970-900-6179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty