Provider Demographics
NPI:1801060793
Name:RAINBOW HOSPICE CORP.
Entity type:Organization
Organization Name:RAINBOW HOSPICE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:PAZ
Authorized Official - Last Name:ASUNCION
Authorized Official - Suffix:JR
Authorized Official - Credentials:RT, CRT
Authorized Official - Phone:1805-526-0269
Mailing Address - Street 1:2139 TAPO ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3478
Mailing Address - Country:US
Mailing Address - Phone:805-526-0269
Mailing Address - Fax:805-526-0521
Practice Address - Street 1:2139 TAPO ST
Practice Address - Street 2:SUITE 213
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3478
Practice Address - Country:US
Practice Address - Phone:805-526-0269
Practice Address - Fax:805-526-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000554251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based