Provider Demographics
NPI:1568345809
Name:THE WELLNEST OF THE QUAD CITIES
Entity type:Organization
Organization Name:THE WELLNEST OF THE QUAD CITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSBY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:563-279-2017
Mailing Address - Street 1:19120 134TH AVE W
Mailing Address - Street 2:
Mailing Address - City:TAYLOR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:61284-9100
Mailing Address - Country:US
Mailing Address - Phone:309-269-5185
Mailing Address - Fax:
Practice Address - Street 1:430 W 35TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806
Practice Address - Country:US
Practice Address - Phone:563-279-2107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)