Organization
NEW MOON WELLNESS QC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M HUDSON LMHC (OWNER)
(563) 484-0266
Entity
Organization
Contact information
Practice address
2435 KIMBERLY RD STE 205N, BETTENDORF, IA 52722-3521
(563) 484-0266
Mailing address
PO BOX 162, MC CAUSLAND, IA 52758-0162
(563) 484-0266
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/11/2023
Last updated
06/03/2024
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