Provider Demographics
NPI:1932515038
Name:OVER THE RAINBOW, INC.
Entity Type:Organization
Organization Name:OVER THE RAINBOW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-638-9599
Mailing Address - Street 1:110 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-2701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:330-638-9575
Practice Address - Street 1:110 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-2701
Practice Address - Country:US
Practice Address - Phone:330-638-9599
Practice Address - Fax:330-638-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2043041Medicaid