Provider Demographics
NPI:1063887636
Name:RAINBOW ADHC OF QUINCY LLC
Entity type:Organization
Organization Name:RAINBOW ADHC OF QUINCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VINOKUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-370-4714
Mailing Address - Street 1:100 PARKINGWAY
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5058
Mailing Address - Country:US
Mailing Address - Phone:301-370-4714
Mailing Address - Fax:301-560-8270
Practice Address - Street 1:100 PARKINGWAY
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5058
Practice Address - Country:US
Practice Address - Phone:301-370-4714
Practice Address - Fax:301-560-8270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care