| Quad Cities Mental Health | |
|
4350 7th St Moline IL 61265-6870 | |
| (309) 764-5040 | |
| (309) 764-9001 |
| Full Name | Quad Cities Mental Health |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 4350 7th St, Moline, Illinois |
| Authorized Official Name and Position | Gonchigari Narayana (OWNER) |
| Authorized Official Contact | 3097645040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quad Cities Mental Health 4350 7th St Moline IL 61265-6870 Ph: (309) 764-5040 | Quad Cities Mental Health 4350 7th St Moline IL 61265-6870 Ph: (309) 764-5040 |
| NPI Number | 1679010771 |
|---|---|
| Provider Enumeration Date | 01/26/2017 |
| Last Update Date | 01/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679010771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 336.042316 (Illinois) | Primary |
| 251S00000X | Community/behavioral Health | 180.006915 (Illinois) | Secondary |
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