RANBOW LLC


Address: 130 Stockham Blvd., Rigby, ID 83442
Phone: 2087456930

RANBOW LLC (NPI# 1508400912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508400912
Entity Type Organization
Organization Name RANBOW LLC
Practice Address 130 Stockham Blvd.
Rigby
ID 83442
Mailing Address 859 S. Yellostone Hwy. Ste 101
Rexburg
ID 83440
Practice Telephone 2087456930
Mailing Telephone 2082448319
Enumeration Date 2019-10-30
Last Update Date 2019-10-30
Authorized Official Name LESLIE BOWEN (OWNER)
Authorized Official Telephone 2082448319
Is Organization Subpart Y
Parent Organization Name RANBOW LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
The Wildflower of Rigby Doing Business As Name - Organization

Office Location

Street Address 130 STOCKHAM BLVD.
City RIGBY
State ID
Zip Code 83442

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1457856429 Kayla Childers Speech-Language Pathologist 152 E. Main Street, Rigby, ID 83442 2018-03-29
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1821466376 Chad Judy Speech-Language Pathologist 152 E Main Street, Suite 110, Rigby, ID 83442 2015-09-14
1740588276 Jessica Brodie Speech-Language Pathologist 165 Front Street, Driggs, ID 83442 2011-03-08
1255636304 Kathy Lebaron Midwife 297n 3855 East, Rigby, ID 83442 2011-01-21
1780834077 Agape Birth Service and Birth Center Midwife 297 N 3855 East, Rigby, ID 83442 2008-09-24
1548431588 Valley Orthodontics Dentist 197 Stockham Blvd, Suite A, Rigby, ID 83442 2008-03-18
1689885238 Aspen Center Rehabilitation and Counseling LLC Clinic/Center 140 N. 1st E., Driggs, ID 83442 2007-05-25
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Notes: [7/1/2003: new]

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1164046413 Grace Memory Care At State Street LLC Assisted Living Facility 9779 W State St, Boise, ID 83714-1638 2020-06-02
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Competitor

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City RIGBY
Zip Code 83442

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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