Organization
QUAD CITIES MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GONCHIGARI NARAYANA M.D. (OWNER)
(309) 764-5040
Entity
Organization
Contact information
Practice address
4350 7TH ST, MOLINE, IL 61265-6870
(309) 764-5040
(309) 764-9001
Mailing address
4350 7TH ST, MOLINE, IL 61265-6870
(309) 764-5040
(309) 764-9001
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
336.042316
IL
251S00000X
Community/Behavioral Health Agency
180.006915
IL
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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