Provider Demographics
NPI:1063629244
Name:RAINEY, LENEE NICOLE (MHPP)
Entity type:Individual
Prefix:MS
First Name:LENEE
Middle Name:NICOLE
Last Name:RAINEY
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 STAGECOACH RD
Mailing Address - Street 2:1311
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-7059
Mailing Address - Country:US
Mailing Address - Phone:501-993-4287
Mailing Address - Fax:
Practice Address - Street 1:9400 STAGECOACH RD
Practice Address - Street 2:1311
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-7059
Practice Address - Country:US
Practice Address - Phone:501-993-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services