Provider Demographics
NPI:1558075184
Name:RAINBOW FAMILY WELLNESS
Entity Type:Organization
Organization Name:RAINBOW FAMILY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-228-0253
Mailing Address - Street 1:3629 RANDALL CT
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-4640
Mailing Address - Country:US
Mailing Address - Phone:727-228-0253
Mailing Address - Fax:
Practice Address - Street 1:3629 RANDALL CT
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4640
Practice Address - Country:US
Practice Address - Phone:727-228-0253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty