Provider Demographics
NPI:1831242916
Name:RAINBOW HOME HEALTH, INC
Entity type:Organization
Organization Name:RAINBOW HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:580-298-3272
Mailing Address - Street 1:1 89535 N 4156 RD
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-1358
Mailing Address - Country:US
Mailing Address - Phone:580-298-3272
Mailing Address - Fax:580-298-9910
Practice Address - Street 1:400 SW C ST STE B
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-3850
Practice Address - Country:US
Practice Address - Phone:580-298-3272
Practice Address - Fax:580-298-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OK7684251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377630Medicare ID - Type Unspecified