NPIMap

Organization Active NPI

River Bend Christian Counseling Inc

  • Substance Abuse Rehabilitation Facility
  • Moline, IL
National Provider Identifier
1639170285
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A-3692-0001-A Issued in IL
Legal business name
RIVER BEND CHRISTIAN COUNSELING INC
Practice address
111 19TH Ave
Moline, IL 61265
Phone
(309) 757-0300
Fax
(309) 757-0400
NPI assigned
Aug 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Al R Doyle, MD
Title
Medical Director
Phone
(309) 757-0300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-3692-0001-A IL
Substance Abuse Rehabilitation Facility 324500000X A-3692-0001-A IL Primary

Addresses

Primary practice location

111 19TH Ave
Moline, IL 61265

Mailing address

111 19TH Ave
Moline, IL 61265-3754
Phone (309) 757-0300

Other identifiers 1

IdentifierTypeStateIssuer
1639170285MedicaidIL

Other names 1

  • River Bend Christian Counseling Former legal business name

National Provider Directory

National Provider Directory

Locations

2435 Kimberly Rd
#155
Bettendorf, IA 52722
Phone (563) 359-7625

Practitioners & affiliated clinicians

Practitioners 6

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": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1639170285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 19TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653754",
            "telephone_number": "309-757-0300",
            "fax_number": "309-757-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 19TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "309-757-0300",
            "fax_number": "309-757-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER BEND CHRISTIAN COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "AL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-757-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-3692-0001-A",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-3692-0001-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639170285",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Bend Christian Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "River Bend Christian Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jun 16, 2018; 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.