Organization · Type 2 NPI

Rosecrance New Life Outpatient Center

Substance Use Disorder Rehabilitation Clinic/Center · Davenport, IA

NPI number 1154490985 Active

Practice location

2322 E Kimberly Rd Ste 200 Paul Revere Sq
Davenport, IA 52807-3042

Call (563) 355-0055 Map

Fax (563) 355-0101

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3877

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Substance Use Disorder Rehabilitation Clinic/Center Primary	261QR0405X	1231 (IA)

Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...

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Jackson Recovery CentersSubstance Use Disorder Rehabilitation Clinic/Center Davenport, IA NPI 1508504309

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NPI record

NPI: 1154490985
Entity type: Organization (Type 2)
Issued: Nov 7, 2006
Last updated: Jan 23, 2020
Status: Active
Subpart: Yes of Rosecrance Health Network

Other names

<unavail>
New Outpatient Center · doing business as

Authorized official

John Schuster
Senior Vice President/cfo
(815) 387-5642

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1154490985

Rosecrance New Life Outpatient Center's National Provider Identifier is 1154490985, issued on Nov 7, 2006. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Davenport, IA. The record was last updated on Jan 23, 2020.