Provider Demographics
NPI:1801280631
Name:RAINBOW RESIDENTIALS OF FLORIDA LLC
Entity type:Organization
Organization Name:RAINBOW RESIDENTIALS OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-203-7384
Mailing Address - Street 1:2181 SEAPORT CIR
Mailing Address - Street 2:APT 211
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1265
Mailing Address - Country:US
Mailing Address - Phone:407-990-1870
Mailing Address - Fax:
Practice Address - Street 1:2181 SEAPORT CIR
Practice Address - Street 2:APT 211
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1265
Practice Address - Country:US
Practice Address - Phone:407-990-1870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233657372500000X, 376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL233657OtherAHCA