NPIMap

Organization Active NPI

Rainbow Spectrum Therapy

  • Early Intervention Provider Agency
  • Brooklyn Park, MN
National Provider Identifier
1457948275
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
RAINBOW SPECTRUM THERAPY
Practice address
8570 Edinburgh Centre Dr
Brooklyn Park, MN 55443
Phone
(763) 347-1017
NPI assigned
Dec 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roda MahamoudNPI 1720686660
Title
Owner
Phone
(763) 347-1017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

8570 Edinburgh Centre Dr
Brooklyn Park, MN 55443

Mailing address

8570 Edinburgh Centre Dr
Brooklyn Park, MN 55443

National Provider Directory

National Provider Directory

Locations

8570 Edinburgh Center Dr
Brooklyn Park, MN 55443
Phone (763) 347-1017

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1457948275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8570 EDINBURGH CENTRE DR",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8570 EDINBURGH CENTRE DR",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55443",
            "telephone_number": "763-347-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW SPECTRUM THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "MAHAMOUD",
        "authorized_official_first_name": "RODA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-347-1017"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.