Provider Demographics
NPI:1659191732
Name:UNDER THE RAINBOW LLC
Entity type:Organization
Organization Name:UNDER THE RAINBOW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MADSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-853-6944
Mailing Address - Street 1:1515 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-3428
Mailing Address - Country:US
Mailing Address - Phone:715-524-4006
Mailing Address - Fax:715-524-5595
Practice Address - Street 1:1515 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-3428
Practice Address - Country:US
Practice Address - Phone:715-524-4006
Practice Address - Fax:715-524-5595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child