FAMILY RESOURCES INC (NPI# 1275598054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275598054 |
Entity Type | Organization |
Organization Name | FAMILY RESOURCES INC |
Practice Address |
2800 Eastern Ave Davenport IA 52803 |
Practice Telephone | 5633266431 |
Practice Fax Number | 5633262013 |
Mailing Telephone | 5633266431 |
Mailing Fax Number | 5633262013 |
Enumeration Date | 2006-04-18 |
Last Update Date | 2009-06-09 |
Authorized Official Name | MS. CHERYL E GOODWIN (C.E.O.) |
Authorized Official Telephone | 5633266431 |
Authorized Official Credential | M.C.J., L.M.S.W. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251S00000X | Community/Behavioral Health | IA | Agencies | |
N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | IA | Residential Treatment Facilities | |
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | IA | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IA | 1102749 | 05 | |
IA | 0465559 | 05 | |
IA | 0102749 | 05 |
Street Address |
2800 EASTERN AVE |
City | DAVENPORT |
State | IA |
Zip Code | 52803 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669003398 | Erica Michelle Lynne Lee | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2020-01-31 |
1386204519 | Mara Lynn Doye | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2019-06-19 |
1578036364 | Brooke Daniele Bowman | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2019-01-04 |
1043669351 | Nicole Cesar | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2016-06-07 |
1740641034 | Rose Lynn Almquist | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2016-03-14 |
1215326673 | Roberta Hodge | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2015-01-22 |
1528312964 | Kate Lempke | Counselor | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2012-11-07 |
1124373402 | Lisa Kimberly Livingston | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2012-07-23 |
1639451370 | Laura Elinor Anderson | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2011-09-19 |
1841588100 | Nancy Jo Maday | Social Worker | 2800 Eastern Ave, Davenport, IA 52803-2012 | 2011-07-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679189971 | Amber Rae Rupiper | Physician Assistant | 518 Locus Street, Davenport, IA 52803 | 2020-09-22 |
1558869321 | Devan Louis Depauw | Physician Assistant | 1227 East Rusholme St., Davenport, IA 52803 | 2018-01-26 |
1215383070 | Brittney N Hughes | Nurse Practitioner | 1228 E Rusholme Street, Suite 3020, Davenport, IA 52803 | 2016-05-11 |
1992138747 | Sarah Beth Schlickman | Nurse Practitioner | 1228 E Rusholme St Ste 3020, Davenport, IA 52803 | 2013-08-15 |
1154763845 | Leslie A Poston | Nurse Practitioner | 1228 E. Rushome Street, Mob I, Suite 2100, Davenport, IA 52803 | 2013-07-23 |
1083878896 | Jolene Marie Dague | Dentist | 1905 N. Main St, Davenport, IA 52803 | 2008-07-11 |
1952436370 | Joann C Milani | Psychologist | 1503 Brady Street, Davenport, IL 52803 | 2007-02-23 |
1942343579 | Lisa Clare Ploehn | Pharmacist | 129 West Locust Street, Davenport, IA 52803 | 2007-02-14 |
1366597957 | Cathleen Ann Clark | Social Worker | 1706 N Brady, Suite 204, Davenport, IA 52803 | 2007-01-24 |
1184781940 | William Burke Ltd | Durable Medical Equipment & Medical Supplies | 129 West Locust, Davenport, IA 52803 | 2007-01-02 |
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Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992256291 | Hillcrest Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 2543 Wilbricht Ln, Dubuque, IA 52001-3034 | 2016-10-21 |
1497959050 | Midwest Christian Services | Residential Treatment Facility, Emotionally Disturbed Children | 4509 20th Ave, Peterson, IA 51047-7524 | 2007-06-14 |
1851415947 | Youth Homes of Mid-america | Residential Treatment Facility, Emotionally Disturbed Children | 7225 Nw 58th St, Johnston, IA 50131-1948 | 2007-03-16 |
1255472882 | Clarinda Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1820 N 16th St, Clarinda, IA 51632-1165 | 2007-02-08 |
1104973148 | Rabiner Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1762 Johnson Ave, Fort Dodge, IA 50501-8408 | 2007-01-04 |
1669531000 | Youth Services International, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4502 230th St, Wallingford, IA 51365-7539 | 2006-12-08 |
1831665785 | Clarinda Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1820 N 16th St, Clarinda, IA 51632-1165 | 2018-10-18 |
1962806158 | Woodward Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1251 334th St, Woodward, IA 50276-7509 | 2014-10-16 |
1245426238 | Youth and Family Resource Services | Residential Treatment Facility, Emotionally Disturbed Children | 200 6th St, Gruver, IA 51334-8518 | 2007-09-24 |
1992839872 | Woodward Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1251 334th St, Woodward, IA 50276-7509 | 2007-03-15 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.