# LAGUNA RAINBOW CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Laguna Rainbow Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316926041
- **Authorized official:** MS. MARY KORETKE (DIRECTOR OF REIMBURSEMENT)
- **Authorized official phone:** (303) 987-3088

## Contact information

- **Practice address:** I-40, EXIT 108, 1/2 MILE SOUTH STATE ROAD 23, CASA BLANCA, NM 87007-0490
- **Practice address phone:** (505) 552-6034
- **Practice address fax:** (505) 552-7645
- **Mailing address:** PO BOX 490, CASA BLANCA, NM 87007-0490
- **Mailing address phone:** (505) 552-6034
- **Mailing address fax:** (505) 552-7645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 5063 | NM | Yes |

## Other

- **Enumeration date:** 01/11/2006
- **Last updated:** 03/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | I0365 | — | NM |