ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH (NPI# 1871542829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871542829 |
| Entity Type | Organization |
| Organization Name | ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH |
| Other Organization Name | ROBERT YOUNG CENTER |
| Practice Address |
2701 17th St Rock Island IL 61201-5351 |
| Mailing Address |
Po Box 5078 Rock Island IL 61204-5078 |
| Practice Telephone | 3097793001 |
| Mailing Telephone | 3097793001 |
| Mailing Fax Number | 3097792555 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2017-10-10 |
| Authorized Official Name | MR. JOSEPH PROVATEARE (DIRECTOR SUPPORT SERVICES) |
| Authorized Official Telephone | 3097792022 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Robert Young Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588196281 | Robert Young Center for Community Mental Health | Clinic/Center | 3100 7th St, East Moline, IL 61244-3262 | 2017-03-31 |
| 1093201410 | Robert Young Center for Community Mental Health | Clinic/Center | 12160 S Utah Ave, Davenport, IA 52804-9537 | 2018-07-09 |
| 1609360163 | Robert Young Center for Community Mental Health | Counselor | 4230 11th St, Rock Island, IL 61201-6746 | 2018-06-19 |
| 1811481450 | Robert Young Center for Community Mental Health | Counselor | 1523 S Fairmount St, Davenport, IA 52802-3644 | 2018-06-18 |
| 1346734985 | Robert Young Center for Community Mental Health | Counselor | 1519 E Locust St, Davenport, IA 52803-3243 | 2018-06-18 |
| 1730685389 | Robert Young Center for Community Mental Health | Substance Abuse Rehabilitation Facility | 1616 Cedar St, Muscatine, IA 52761-3453 | 2018-04-03 |
| 1891227575 | Robert Young Center for Community Mental Health | Clinic/Center | 12200 104th St, Coal Valley, IL 61240-9712 | 2017-03-31 |
| 1376909309 | Robert Young Center for Community Mental Health | Community/Behavioral Health | 4600 3rd St, Moline, IL 61265-6106 | 2016-01-06 |
| Street Address |
2701 17TH ST |
| City | ROCK ISLAND |
| State | IL |
| Zip Code | 61201-5351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142629 | Deepak Ahuja | Internal Medicine | 2701 17th St, Rock Island, IL 61201-5351 | 2005-05-31 |
| 1205436052 | Penny Ann Liebbe | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-30 |
| 1740880863 | Ginger I Busby | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-28 |
| 1366041022 | Elizabeth Erin Montgomery | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-22 |
| 1285232587 | Jillian Elizabeth Spragg | Counselor | 2701 17th St, Rock Island, IL 61201-5393 | 2020-10-09 |
| 1902403140 | Kelsey Jean Mickelson | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-01 |
| 1033725452 | Amber Michelle Winters | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-21 |
| 1295341865 | Kaitlyn Dawn Shannon | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-19 |
| 1902412539 | Alex Strupp | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-18 |
| 1861008641 | Leanne Elizabeth Zazzetti | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689206245 | Judy Kay Moore | Technician | 2439 8th Ave, Rock Island, IL 61201 | 2020-02-11 |
| 1053956862 | Christina Beam | Counselor | 1413 40th Street, Rock Island, IL 61201 | 2019-11-15 |
| 1356843817 | Stephanie Kaye Jones | Counselor | 2701 17th St., Rock Island, IL 61201 | 2018-03-01 |
| 1073062030 | Innovative Transport Enterprise, LLC | Non-emergency Medical Transport (VAN) | 2239 24th Street Apt 15c, Rock Island, IL 61201 | 2016-09-30 |
| 1124575733 | Robert Young Center | Community Based Residential Treatment Facility, Mental Illness | 2701 - 17 Street, Rockisland, IL 61201 | 2016-09-01 |
| 1538520903 | James Keith Frainey | Psychologist | 805 19th Street, Transitions Mhs, Rock Island, IL 61201 | 2016-03-14 |
| 1417340837 | Brandon Lee Sachwitz | Physician Assistant | 2701 17th Street, Trinity Medical Center, Rock Island, IL 61201 | 2015-03-10 |
| 1215366679 | Kimberly Lyall | Physical Therapy Assistant | 767 30th Street, Rock Island, IL 61201 | 2013-11-06 |
| 1386080745 | The Abbey Center, LLC | Clinic/Center | 3031 5th Ave., Rock Island, IL 61201 | 2013-05-13 |
| 1487097382 | Joe Lee Westerhof | Veterinarian | 2529 11th St, Rock Island, IL 61201 | 2013-04-10 |
| Find all providers in zip 61201 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386080745 | The Abbey Center, LLC | Clinic/Center | 3031 5th Ave., Rock Island, IL 61201 | 2013-05-13 |
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| 1093354037 | A Bridge Back, Inc. | Clinic/Center | 314 Mchenry Rd, Buffalo Grove, IL 60089-2428 | 2019-12-21 |
| Find all providers with the same taxonomy | ||||
| City | ROCK ISLAND |
| Zip Code | 61201 |
Please comment or provide details below to improve the information on ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH.
| 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.