Organization
PROJECT STARPHISH
Active
Parent organization
REIGNBOW ENTERPRISES
Organization subpart
Yes
Provider details
NPI number
Legal business name
REIGNBOW ENTERPRISES
Authorized official
MS. LESLIE M RANDOLPH ADMINISTRATOR (ADMINISTRATOR OF PROGRAM SUPPORT)
(814) 661-2780
Entity
Organization
Contact information
Practice address
10987 ROUTE 322, SHIPPENVILLE, PA 16254-4837
(814) 661-2780
Mailing address
PO BOX 771, CLARION, PA 16214-0771
(814) 661-2780
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
444590
PA
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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