Healthcare Provider Details

I. General information

NPI: 1447165469
Provider Name (Legal Business Name): QUAD CITIES INTERVENTION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 41ST ST
MOLINE IL
61265-7859
US

IV. Provider business mailing address

1019 23RD AVE
MOLINE IL
61265-4771
US

V. Phone/Fax

Practice location:
  • Phone: 309-269-2591
  • Fax: 309-269-2591
Mailing address:
  • Phone: 309-269-2591
  • Fax: 309-269-2591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIDGETT YVONNE ALLEN
Title or Position: OWNER
Credential:
Phone: 309-269-2591