Healthcare Provider Details

I. General information

NPI: 1710276399
Provider Name (Legal Business Name): THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 17TH ST
ROCK ISLAND IL
61201-5351
US

IV. Provider business mailing address

4600 3RD ST
MOLINE IL
61265-6106
US

V. Phone/Fax

Practice location:
  • Phone: 309-779-3000
  • Fax: 309-779-2078
Mailing address:
  • Phone: 309-779-2031
  • Fax: 309-779-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: DENNIS DUKE
Title or Position: PRESIDENT
Credential:
Phone: 309-779-2043