NPIMap

Organization Active NPI

Bethany for Children & Families

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moline, IL
National Provider Identifier
1174228639
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BETHANY FOR CHILDREN & FAMILIES
Practice address
1701 River Dr Ste 200
Moline, IL 61265-1384
Phone
(309) 797-7700
Fax
(309) 797-2386
NPI assigned
Apr 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Lisa Christopher
Title
Contracting Credentialing Coordinat
Phone
(563) 327-0203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1701 River Dr Ste 200
Moline, IL 61265-1384

Mailing address

1701 River Dr Ste 200
Moline, IL 61265-1384
Phone (309) 797-7700

Other identifiers 1

IdentifierTypeStateIssuer
1B00-IPI-014MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Bethany for Children Families3 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.

Locations

1701 River Dr
Moline, IL 61265
Phone (309) 797-7700

1701 River Dr
Ste 200
Moline, IL 61265
Phone (309) 797-7700

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1174228639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 RIVER DR STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651384",
            "telephone_number": "309-797-7700",
            "fax_number": "563-243-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 RIVER DR STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651384",
            "telephone_number": "309-797-7700",
            "fax_number": "309-797-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY FOR CHILDREN & FAMILIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "CHRISTOPHER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CONTRACTING CREDENTIALING COORDINAT",
        "authorized_official_telephone_number": "563-327-0203"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1B00-IPI-014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.