Provider Demographics
NPI:1881008654
Name:RAINBOW HEALTH CARE
Entity Type:Organization
Organization Name:RAINBOW HEALTH CARE
Other - Org Name:RAINBOW HEALTH CARE COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JUDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BIENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-631-3000
Mailing Address - Street 1:111 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:OK
Mailing Address - Zip Code:74010-3444
Mailing Address - Country:US
Mailing Address - Phone:918-367-2246
Mailing Address - Fax:918-367-5326
Practice Address - Street 1:111 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:OK
Practice Address - Zip Code:74010-3444
Practice Address - Country:US
Practice Address - Phone:918-367-2246
Practice Address - Fax:918-367-5326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCC1901314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375320Medicare Oscar/Certification