Provider Demographics
NPI:1245368489
Name:COMMUNITY SERVICE OPTIONS FOR ROCK ISLAND MERCER COUNTIES
Entity type:Organization
Organization Name:COMMUNITY SERVICE OPTIONS FOR ROCK ISLAND MERCER COUNTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:IMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-278-0020
Mailing Address - Street 1:3601 MORTON DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244-1917
Mailing Address - Country:US
Mailing Address - Phone:309-278-0020
Mailing Address - Fax:309-278-0024
Practice Address - Street 1:3601 MORTON DR
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-1917
Practice Address - Country:US
Practice Address - Phone:309-278-0020
Practice Address - Fax:309-278-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management