| Quad Cities Service Providers, Llc | |
|
5433 Tremont Ave Davenport IA 52807 | |
| (563) 343-9874 | |
| Not Available |
| Full Name | Quad Cities Service Providers, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5433 Tremont Ave, Davenport, Iowa |
| Authorized Official Name and Position | Mary C. Allen-des Jardins (OWNER) |
| Authorized Official Contact | 5633439874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quad Cities Service Providers, Llc 5433 Tremont Ave Davenport IA 52807 Ph: (563) 343-9874 | Quad Cities Service Providers, Llc 5433 Tremont Ave Davenport IA 52807 Ph: (563) 343-9874 |
| NPI Number | 1255601464 |
|---|---|
| Provider Enumeration Date | 01/04/2012 |
| Last Update Date | 06/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255601464 | NPI | - | NPPES |
| 1255601464 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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