Organization
RAINBOW RIDGE#2,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL JEAN BRASWELL HOME PROVIDER (MANAGER/OWNER)
(478) 289-9000
Entity
Organization
Contact information
Practice address
181 RAINBOW RDG, SWAINSBORO, GA 30401-4413
(478) 289-9000
(478) 289-6945
Mailing address
181 RAINBOW RDG, SWAINSBORO, GA 30401-4413
(478) 289-9000
(478) 289-6945
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
053010291
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018090102A
—
GA
Enumeration date
12/31/2011
Last updated
12/31/2011
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