Healthcare Provider Details

I. General information

NPI: 1164134490
Provider Name (Legal Business Name): ALLURE OF THE QUAD CITIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 16TH AVE
MOLINE IL
61265-3808
US

IV. Provider business mailing address

2711 W HOWARD ST
CHICAGO IL
60645-1303
US

V. Phone/Fax

Practice location:
  • Phone: 309-764-6744
  • Fax: 309-764-8176
Mailing address:
  • Phone: 773-338-4400
  • Fax: 773-338-4414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SAMANTHA MEYER
Title or Position: MANAGER
Credential:
Phone: 773-338-4400