Rainbow Ridge#2&#3,Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

053010291 Issued in GA

Legal business name

RAINBOW RIDGE#2&#3,INC.

Practice address

181 Rainbow RDG
Swainsboro, GA 30401-4413

Phone

(478) 289-9000

Fax

(478) 289-6945

NPI assigned

Dec 31, 2011

Last updated

Dec 31, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Jean Braswell, HOME PROVIDER

Title

Manager/Owner

Phone

(478) 289-9000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1325289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325289600000",
    "number": "1609146109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 RAINBOW RDG",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304014413",
            "telephone_number": "478-289-9000",
            "fax_number": "478-289-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 RAINBOW RDG",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304014413",
            "telephone_number": "478-289-9000",
            "fax_number": "478-289-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW RIDGE#2&#3,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-31",
        "last_updated": "2011-12-31",
        "status": "A",
        "authorized_official_last_name": "BRASWELL",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "478-289-9000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "HOME PROVIDER"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "GA",
            "license": "053010291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018090102A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Swainsboro, GA
• Providers in Swainsboro, GA by specialty
• Intellectual Disabilities Intermediate Care Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2011; 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.