Provider Demographics
NPI:1396468294
Name:RAINBOWS END
Entity type:Organization
Organization Name:RAINBOWS END
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-479-9414
Mailing Address - Street 1:57 BEERS DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4220
Mailing Address - Country:US
Mailing Address - Phone:845-479-9414
Mailing Address - Fax:
Practice Address - Street 1:57 BEERS DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4220
Practice Address - Country:US
Practice Address - Phone:845-479-9414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)