Organization
QUAD CITIES SERVICE PROVIDERS, LLC
Active
Other names
Former name: Allen Autism Behavioral Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY C. ALLEN-DES JARDINS (OWNER)
(563) 343-9874
Entity
Organization
Contact information
Practice address
5433 TREMONT AVE, DAVENPORT, IA 52807
(563) 343-9874
Mailing address
5433 TREMONT AVE, DAVENPORT, IA 52807
(563) 343-9874
(563) 888-5718
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255601464
—
IA
Enumeration date
01/04/2012
Last updated
06/20/2019
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