Provider Demographics
NPI: | 1780866715 |
---|---|
Name: | RAINDANCE HEALTHCARE GROUP, INC. |
Entity Type: | Organization |
Organization Name: | RAINDANCE HEALTHCARE GROUP, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ANDREW |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TURNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 206-927-6666 |
Mailing Address - Street 1: | 3510 SPENARD RD STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | ANCHORAGE |
Mailing Address - State: | AK |
Mailing Address - Zip Code: | 99503-3777 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-927-6666 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3510 SPENARD RD STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | ANCHORAGE |
Practice Address - State: | AK |
Practice Address - Zip Code: | 99503-3777 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-927-6666 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-11-30 |
Last Update Date: | 2007-11-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AK | APPLICATION PENDING | 314000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |