NPIMap

Organization Active NPI

New Life Outpatient Center

  • Community/Behavioral Health Agency
  • Davenport, IA
National Provider Identifier
1740651579
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
101YA0400X Issued in IA
Legal business name
NEW LIFE OUTPATIENT CENTER
Practice address
2322 E Kimberly Rd
Ste. 200 North
Davenport, IA 52807-7205
Phone
(563) 355-0055
Fax
(563) 355-0101
NPI assigned
Oct 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Austin Gross, IADC
Title
Clinical Manager
Phone
(563) 355-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 101YA0400X IA Primary

Addresses

Primary practice location

2322 E Kimberly Rd
Ste. 200 North
Davenport, IA 52807-7205

Mailing address

2322 E Kimberly Rd
Ste. 200 North
Davenport, IA 52807-7205
Phone (563) 355-0055

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1740651579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 E KIMBERLY RD",
            "address_2": "STE. 200 NORTH",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528077205",
            "telephone_number": "563-355-0055",
            "fax_number": "563-355-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 E KIMBERLY RD",
            "address_2": "STE. 200 NORTH",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528077205",
            "telephone_number": "563-355-0055",
            "fax_number": "563-355-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE OUTPATIENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "563-355-0055",
        "authorized_official_credential": "IADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": "101YA0400X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.