Healthcare Provider Details

I. General information

NPI: 1275598054
Provider Name (Legal Business Name): FAMILY RESOURCES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 W LOMBARD ST
DAVENPORT IA
52804-2148
US

IV. Provider business mailing address

1414 W LOMBARD ST
DAVENPORT IA
52804-2148
US

V. Phone/Fax

Practice location:
  • Phone: 563-326-6431
  • Fax: 563-326-2013
Mailing address:
  • Phone: 563-326-6431
  • Fax: 563-326-2013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateIA

VIII. Authorized Official

Name: MS. DEENA DHUSE
Title or Position: MANAGER MENTAL HEALTH
Credential:
Phone: 563-468-2145