Provider Demographics
NPI:1770664997
Name:RAINBOW BEHAVIORAL HEALTH SERVICES CHARTERED
Entity Type:Organization
Organization Name:RAINBOW BEHAVIORAL HEALTH SERVICES CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRINKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LP, LPC
Authorized Official - Phone:507-831-4699
Mailing Address - Street 1:305 9TH ST
Mailing Address - Street 2:P O BOX 443
Mailing Address - City:WINDOM
Mailing Address - State:MN
Mailing Address - Zip Code:56101-0443
Mailing Address - Country:US
Mailing Address - Phone:507-831-4699
Mailing Address - Fax:507-831-4755
Practice Address - Street 1:305 9TH ST
Practice Address - Street 2:
Practice Address - City:WINDOM
Practice Address - State:MN
Practice Address - Zip Code:56101-0443
Practice Address - Country:US
Practice Address - Phone:507-831-4699
Practice Address - Fax:507-831-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3769103T00000X
MN830918-2-CDT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Not Answered251S00000XAgenciesCommunity/Behavioral Health