Provider Demographics
NPI:1720122690
Name:MARCIA CHRISTIANSEN
Entity Type:Organization
Organization Name:MARCIA CHRISTIANSEN
Other - Org Name:RAINBOW HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA, BSW
Authorized Official - Phone:920-684-4851
Mailing Address - Street 1:3100 SOUTHBROOK CT
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-5999
Mailing Address - Country:US
Mailing Address - Phone:920-684-4851
Mailing Address - Fax:920-684-6106
Practice Address - Street 1:3100 SOUTHBROOK CT
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5999
Practice Address - Country:US
Practice Address - Phone:920-684-4851
Practice Address - Fax:920-684-6106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility