Provider Demographics
NPI:1265115760
Name:RAINBOW MENTAL HEALTH, PLLC
Entity type:Organization
Organization Name:RAINBOW MENTAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARMONY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:224-263-4671
Mailing Address - Street 1:3500 WESTERN AVE STE 1D
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-1263
Mailing Address - Country:US
Mailing Address - Phone:224-263-4671
Mailing Address - Fax:224-346-6471
Practice Address - Street 1:3500 WESTERN AVE STE 1D
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-1263
Practice Address - Country:US
Practice Address - Phone:224-263-4671
Practice Address - Fax:224-346-6471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)