| Sbh-davenport, Llc | |
|
770 Tanglefoot Ln Bettendorf IA 52722-1608 | |
| (563) 396-2100 | |
| Not Available |
| Full Name | Sbh-davenport, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 770 Tanglefoot Ln, Bettendorf, Iowa |
| Authorized Official Name and Position | Paul Gilbert (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 6155455519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sbh-davenport, Llc 770 Tanglefoot Ln Bettendorf IA 52722-1608 Ph: (563) 396-2100 | Sbh-davenport, Llc 770 Tanglefoot Ln Bettendorf IA 52722-1608 Ph: (563) 396-2100 |
| NPI Number | 1023817475 |
|---|---|
| Provider Enumeration Date | 03/10/2025 |
| Last Update Date | 03/10/2025 |
| Certification Date | 03/10/2025 |
| Medicare PECOS PAC ID | 1759702756 |
|---|---|
| Medicare Enrollment ID | O20210107001935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023817475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Sydnee Jean Hogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548779291 PECOS PAC ID: 7517223258 Enrollment ID: I20171113001313 |
| Provider Name | Spencer J Kissel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013499029 PECOS PAC ID: 4880948140 Enrollment ID: I20200218001918 |
| Provider Name | Anne Leinart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902209737 PECOS PAC ID: 1052614138 Enrollment ID: I20210111001392 |
| Provider Name | Chelsea Lynn Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134876436 PECOS PAC ID: 7416343561 Enrollment ID: I20220330000518 |
| Provider Name | Molly Saucer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962151910 PECOS PAC ID: 0749667780 Enrollment ID: I20220513000844 |
| Provider Name | Kati Wijdenes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295181071 PECOS PAC ID: 4486006251 Enrollment ID: I20240117001835 |
| Provider Name | Rakeshkumar Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013998004 PECOS PAC ID: 0840298410 Enrollment ID: I20240307000235 |
| Provider Name | Allison Rose Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972378529 PECOS PAC ID: 8224479092 Enrollment ID: I20240510000393 |
| Provider Name | Savannah Rasnic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699403022 PECOS PAC ID: 4688028871 Enrollment ID: I20240516003465 |
| Provider Name | Jennifer Marie Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912770850 PECOS PAC ID: 0648612564 Enrollment ID: I20240531000601 |
| Provider Name | Ashley Danielle Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073231478 PECOS PAC ID: 2466894449 Enrollment ID: I20240610003549 |
| Provider Name | Shane Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285117606 PECOS PAC ID: 1951631472 Enrollment ID: I20240819002147 |
| Provider Name | Taylor Thacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114784865 PECOS PAC ID: 7911445002 Enrollment ID: I20240820004596 |
| Provider Name | Holly Lyn Bulver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245911080 PECOS PAC ID: 2264972215 Enrollment ID: I20240905002552 |
| Provider Name | Zachary Stewart Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720860315 PECOS PAC ID: 5991245862 Enrollment ID: I20240905003472 |
| Provider Name | Brandon S Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184430308 PECOS PAC ID: 7012444987 Enrollment ID: I20241217003260 |
Bloom Wellness Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3350 Utica Ridge Rd, Bettendorf, IA 52722 Phone: 563-265-5063 | |
Family Foundations Of Iowa, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2435 Kimberly Rd, Suite 155, Bettendorf, IA 52722 Phone: 563-359-7625 Fax: 563-459-0494 | |
Carter's Counseling Services, Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 Lincoln Rd Ste 209, Bettendorf, IA 52722 Phone: 563-570-7699 | |
Bloom Business Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3350 Utica Ridge Rd, Bettendorf, IA 52722 Phone: 563-271-4143 Fax: 877-583-4958 | |
Robin Peterson Psy D Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1035 Lincoln Rd Ste 202, Bettendorf, IA 52722 Phone: 563-355-4879 | |
Family Counseling & Psychology Center P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2485 Tech Dr, Bettendorf, IA 52722 Phone: 563-355-1611 Fax: 563-355-6617 |