Provider Demographics
NPI:1679897821
Name:RAINBOW FAMILY LIFE CENTER
Entity type:Organization
Organization Name:RAINBOW FAMILY LIFE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEDREA
Authorized Official - Middle Name:LARRETTE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-401-3035
Mailing Address - Street 1:320 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1152
Mailing Address - Country:US
Mailing Address - Phone:989-754-9000
Mailing Address - Fax:989-754-9079
Practice Address - Street 1:804 S HAMILTON ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-1516
Practice Address - Country:US
Practice Address - Phone:989-401-3035
Practice Address - Fax:989-401-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare