Healthcare Provider Details

I. General information

NPI: 1982475570
Provider Name (Legal Business Name): BETHANY FOR CHILDREN & FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 RIVER DR
MOLINE IL
61265-1384
US

IV. Provider business mailing address

1701 RIVER DR
MOLINE IL
61265-1384
US

V. Phone/Fax

Practice location:
  • Phone: 309-797-7700
  • Fax: 309-797-2386
Mailing address:
  • Phone: 309-797-7700
  • Fax: 309-797-2386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM PHILIP STEINHAUSER
Title or Position: CEO
Credential:
Phone: 309-797-7700