| Rainbow Cafe Lgbtq Center | |
|
120 N Illinois Ave Carbondale IL 62901-1450 | |
| (618) 525-9922 | |
| Not Available |
| Full Name | Rainbow Cafe Lgbtq Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 120 N Illinois Ave, Carbondale, Illinois |
| Authorized Official Name and Position | Alexander Socorro (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6189147249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainbow Cafe Lgbtq Center 118 N Illinois Ave Carbondale IL 62901-1450 Ph: (618) 525-9922 | Rainbow Cafe Lgbtq Center 120 N Illinois Ave Carbondale IL 62901-1450 Ph: (618) 525-9922 |
| NPI Number | 1457033763 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 07/16/2025 |
| Certification Date | 07/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457033763 | NPI | - | NPPES |
| BHC-2427502 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Shawnee Health Service And Development Corp Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1025 N Wall St Rm 102, Carbondale, IL 62901 Phone: 618-519-9200 | |
Southern Il Regional Social Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 E College St, Carbondale, IL 62901 Phone: 618-457-6703 Fax: 618-457-8377 | |
Centerstone Of Illinois Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 S Lewis Ln, Carbondale, IL 62901 Phone: 618-937-6483 | |
Behavioral Services Of Southern Illinois Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Blackberry Ln, Carbondale, IL 62903 Phone: 618-303-9282 Fax: 618-319-1122 | |
Synapse Collaborative Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 Cedar Ct, Carbondale, IL 62901 Phone: 618-467-8805 Fax: 618-766-8073 | |
Centerstone Of Illinois Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 E College St, Carbondale, IL 62901 Phone: 618-937-6483 Fax: 618-937-1440 | |
Centerstone Of Illinois Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 E College St, Carbondale, IL 62901 Phone: 618-937-6483 |