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NPI #1558671560 in Rock Island, Illinois

Provider Information

NPI Number
1558671560
Entity Type
Organization
Organization Name
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Subpart
Yes (part of a larger organization)
Parent Organization
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Primary Specialty
Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date
Oct 12, 2010
Last Updated
Jan 17, 2020

Practice Location

Address
827 19TH ST
ZIP Code
61201-2514
Phone
(309) 793-4993

Authorized Official

Name
MS. KRISTIN L RODGERS
Title
CHIEF FINANCIAL OFFICER
Phone
(309) 283-1224

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Mental Health (Including Community Mental Health Center)Mental Health (Including Community Mental Health Center)

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