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Kerry Mendoza
Mental Illness Community Based Residential Treatment Facility in Rock Island, Illinois
NPI 1881138071

Kerry Mendoza is a Mental Illness Community Based Residential Treatment Facility based in Rock Island, IL. Kerry Mendoza practices in Rock Island, IL. The NPI Number for Kerry Mendoza is 1881138071 and holds a License No. (Illinois).

The current practice location address for Kerry Mendoza is 2701 17Th St, Rock Island, IL and can be reached out via phone at 309-779-2957. You can also correspond with Kerry Mendoza through the mailing address at 1854 45TH ST, ROCK ISLAND, IL - 61201-3952 (mailing address contact number: ).

Location: 2701 17Th St, Rock Island, IL, 61201-3952
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1881138071
Provider Name
Kerry Mendoza
Credential
Provider Entity Type
Individual
Gender
Male
Address
2701 17Th St, Rock Island, IL, 61201-3952
Phone Number
309-779-2957
Fax Number
Provider Enumeration Date
12/07/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2701 17Th St
City
Rock Island
State
Illinois
Zip
61201-5351
Phone Number
309-779-2957
Fax Number
person
Provider Business Mailing Address Details
Address
1854 45Th St
City
Rock Island
State
Illinois
Zip
61201-3952
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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