Organization
RAINBOW'S PROMISE THERAPIES, INC.
Active
Other names
Bear Canyon Therapy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS STATON PT (OWNER, CLINICAL DIRECTOR)
(505) 823-2411
Entity
Organization
Contact information
Practice address
5130 SAN FRANCISCO RD NE STE B, ALBUQUERQUE, NM 87109-4618
(505) 823-2411
(505) 858-0650
Mailing address
5130 SAN FRANCISCO RD NE STE B, ALBUQUERQUE, NM 87109-4618
(505) 823-2411
(505) 858-0650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6761
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188126500
ACS
NM
01
—
26790
PRESBYTERIAN HEALTH PLAN
NM
01
—
695957
ACN
NM
01
—
NM00N582
BCBS
NM
Enumeration date
11/28/2006
Last updated
12/27/2024
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