# IGNITE MEDICAL RESORT RAINBOW BOULEVARD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194379065
- **Authorized official:** TIM FIELDS (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (630) 327-2951

## Contact information

- **Practice address:** 3910 RAINBOW BOULEVARD, KANSAS CITY, KS 66103
- **Practice address phone:** (913) 901-8462
- **Mailing address:** 6840 W TOUHY AVENUE, NILES, IL 60714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2019
- **Last updated:** 10/18/2023