Provider Demographics
NPI:1891227575
Name:THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
Entity Type:Organization
Organization Name:THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-779-2043
Mailing Address - Street 1:PO BOX 5078
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61204-5078
Mailing Address - Country:US
Mailing Address - Phone:309-779-2031
Mailing Address - Fax:
Practice Address - Street 1:12200 104TH ST
Practice Address - Street 2:
Practice Address - City:COAL VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61240-9712
Practice Address - Country:US
Practice Address - Phone:309-799-7044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)