Organization
RAINBOW 66 STOREHOUSE, INC. DIVERSITY WITH DESTINY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMMIE BERNITA JOHNSON (CEO)
(910) 276-0766
Entity
Organization
Contact information
Practice address
525 ATKINSON ST, LAURINBURG, NC 28352-3715
(910) 276-0766
Mailing address
525 ATKINSON ST, LAURINBURG, NC 28352-3715
(910) 276-0766
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC2475
NC
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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