Provider Demographics
NPI:1841931235
Name:QC DUI SERVICES
Entity type:Organization
Organization Name:QC DUI SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:309-553-3070
Mailing Address - Street 1:2100 18TH AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-3611
Mailing Address - Country:US
Mailing Address - Phone:563-200-2837
Mailing Address - Fax:309-553-3070
Practice Address - Street 1:2100 18TH AVE STE 6
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-3611
Practice Address - Country:US
Practice Address - Phone:563-200-2837
Practice Address - Fax:309-553-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder