The Robert Young Center for Community Mental Health
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Rock Island, IL
NPI 1710276399 · NPPES record last updated Nov 17, 2021
Key facts
- NPI
- 1710276399
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
- Practice address
- 2701 17TH St
Rock Island, IL 61201-5351 - Phone
- (309) 779-3000
- Fax
- (309) 779-2078
- NPI assigned
- Apr 4, 2011
- Organization subpart
- No
Authorized official
- Name
- Dennis Duke
- Title
- President
- Phone
- (309) 779-2043
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 20
Practitioners 77
-
Treena Adams, APN
-
Jamie Therse Brewer, APRN-CS
-
John C Ciaccio, MD
-
Doyle Evans, MSW, LCSW, LISW
-
Paul Andrew Fecht, NURSE PRACTITIONER
-
Sydnee Jean Hogue, APN, ARNP
-
Paula Jaeger, M.S.ED, LCPC
-
Jamsheed H Khan, M.D.
-
Sheikh Latif, M.D.
-
Penny Ann Liebbe, APN
-
Emily Anne Martin, LCSW
-
Marcey Kay Millage, PMHNP
-
Roxanne Nash, LCSW
-
Birju Patel, MD
-
James J Pugliano, LCSW
-
James A M Sales, MD
-
Michelle R. Shepherd, PMHNP-BC
-
Andrew Graham Sichling, LMSW
-
Julie Lynn Voelker, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211208003044 | IA | Part B Supplier - Clinic/Group Practice | 4587600150 |
Receives reassigned benefits from 43 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: West Liberty, IA; Oelwein, IA; Muscatine, IA; Le Claire, IA; Eldridge, IA; Davenport, IA; Coralville, IA; Bettendorf, IA |
| O20220303002245 | IL | Part B Supplier - Clinic/Group Practice | 4587600150 |
Receives reassigned benefits from 62 practitioners 4 other NPIs on this enrollment Practice locations: Rock Island, IL; Flossmoor, IL; Port Byron, IL; Peoria, IL; Moline, IL; Arlington, IL; Addison, IL |
National Provider Directory
- Tax ID family
- The Robert Young Center for
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Psychiatric Hospital Unit | 273R00000X |
Addresses
Primary practice location
2701 17TH St
Rock Island, IL 61201-5351
Mailing address
4600 3Rd St
Moline, IL 61265-6106
Phone (309) 779-2031
Other providers in Rock Island, IL
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- The Robert Young Center for Community Mental Health
- Erica Theis
- Thomas a Brozovich DC PC
All providers in Rock Island, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.