| Bethany For Children & Families | |
|
1701 River Dr Ste 200 Moline IL 61265-1384 | |
| (309) 797-7700 | |
| (309) 797-2386 |
| Full Name | Bethany For Children & Families |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1701 River Dr Ste 200, Moline, Illinois |
| Authorized Official Name and Position | Lisa Christopher (CONTRACTING CREDENTIALING COORDINAT) |
| Authorized Official Contact | 5633270203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany For Children & Families 1701 River Dr Ste 200 Moline IL 61265-1384 Ph: (309) 797-7700 | Bethany For Children & Families 1701 River Dr Ste 200 Moline IL 61265-1384 Ph: (309) 797-7700 |
| NPI Number | 1174228639 |
|---|---|
| Provider Enumeration Date | 04/04/2023 |
| Last Update Date | 04/11/2025 |
| Certification Date | 04/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174228639 | NPI | - | NPPES |
| 1B00-IPI-014 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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