Provider Demographics
NPI:1720616386
Name:RAINBOW SENIOR HEALTHCARE LLC
Entity Type:Organization
Organization Name:RAINBOW SENIOR HEALTHCARE LLC
Other - Org Name:RAINBOW ADULT DAY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JU
Authorized Official - Middle Name:HWAN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-324-3935
Mailing Address - Street 1:4405 INTERNATIONAL BLVD STE B101
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3013
Mailing Address - Country:US
Mailing Address - Phone:770-696-4304
Mailing Address - Fax:678-824-9089
Practice Address - Street 1:4405 INTERNATIONAL BLVD STE B101
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3013
Practice Address - Country:US
Practice Address - Phone:770-696-4304
Practice Address - Fax:678-824-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care