Rosecrance New Life Outpatient Center

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

1231 Issued in IA

Legal business name

ROSECRANCE NEW LIFE OUTPATIENT CENTER

Practice address

2322 E Kimberly Rd Ste 200 Paul Revere SQ
Davenport, IA 52807-3042

Phone

(563) 355-0055

Fax

(563) 355-0101

NPI assigned

Nov 7, 2006

Organization subpart

Yes

Parent organization

ROSECRANCE HEALTH NETWORKAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Schuster

Title

Senior Vice President/Cfo

Phone

(815) 387-5642

Specialties & licenses 2

Addresses

Other names 1

• New Outpatient Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

New Life Outpatient Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• New Life Outpatient Center

  • Community/Behavioral Health Agency
  • Davenport, IA
  • NPI 1740651579
  NPD tax ID
• New Life Outpatient Center

  • Community/Behavioral Health Agency
  • Davenport, IA
  • NPI 1780966804
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Sappington, MSW, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Davenport, IA
  • NPI 1760316236
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1154490985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-391-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 E KIMBERLY RD STE 200 PAUL REVERE SQ",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073042",
            "telephone_number": "563-355-0055",
            "fax_number": "563-355-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSECRANCE NEW LIFE OUTPATIENT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROSECRANCE HEALTH NETWORK",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "SCHUSTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "815-387-5642"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IA",
            "license": "1231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Outpatient Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kunmin Roo
• Root & Rise Family Health PLLC
• Rooted Learning Behavioral Services
• Roots to Recovery Collective LLC
• Abby Kathleen Rose, D.C.
• Kaitlyn Sue Rosenstiel, DPT
• Ross Medical Supply Company, Inc.
• Jason Patrick Ross, LMHC
• Rachal L. Rossi, APN
• Mariah Rossiter, DC

• Substance Use Disorder Rehabilitation Clinic/Center in Davenport, IA
• Providers in Davenport, IA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.