Quad Cities Interfaith

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

QUAD CITIES INTERFAITH

Practice address

3420 Jersey Ridge Rd
Davenport, IA 52807-2222

Phone

(563) 241-2969

NPI assigned

Sep 7, 2022

Last updated

Sep 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amber Bordolo, MANPI 1932825197

Title

Executive Director

Phone

(563) 241-2969

Specialties & licenses 3

Addresses

Other names 1

• Quad Cities Interfaith Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amber Bordolo

  • Non-emergency Medical Transport (VAN)
  • Clinton, IA
  • NPI 1932825197
  Authorized official Same address or phone

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1376264366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072222",
            "telephone_number": "563-241-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072222",
            "telephone_number": "563-241-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITIES INTERFAITH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "BORDOLO",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "563-241-2969",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quad Cities Interfaith",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Case Management Agency in Davenport, IA
• Providers in Davenport, IA by specialty
• Case Management Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.