Provider Demographics
NPI:1154776326
Name:RAINBOW OF CARE MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:RAINBOW OF CARE MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-718-7076
Mailing Address - Street 1:3100 GENTIAN BLVD
Mailing Address - Street 2:SUITE # 132
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5636
Mailing Address - Country:US
Mailing Address - Phone:706-718-7076
Mailing Address - Fax:888-691-7888
Practice Address - Street 1:3100 GENTIAN BLVD
Practice Address - Street 2:SUITE # 132
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5636
Practice Address - Country:US
Practice Address - Phone:706-718-7076
Practice Address - Fax:888-691-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty