| Rainbow Aba Llc | |
|
100 N Patterson St Ste 117 Valdosta GA 31601-5570 | |
| (404) 590-2550 | |
| Not Available |
| Full Name | Rainbow Aba Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 N Patterson St Ste 117, Valdosta, Georgia |
| Authorized Official Name and Position | Moshe Jacobovitch (MANAGER) |
| Authorized Official Contact | 4408413857 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainbow Aba Llc 100 N Patterson St Ste 117 Valdosta GA 31601-5570 Ph: (440) 841-3857 | Rainbow Aba Llc 100 N Patterson St Ste 117 Valdosta GA 31601-5570 Ph: (404) 590-2550 |
| NPI Number | 1609599315 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609599315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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