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16D2161948 CLIA NUMBER - VERA FRENCH PINE MEADOWS

Laboratory Demographics

CLIA Number: 16D2161948

Facility Name: VERA FRENCH PINE MEADOWS

Facility Address:
4656 W KIMBERLY ROAD
DAVENPORT, IA
ZIP 52806
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Facility Phone Number: 563 345-6573

Facility Type: Other - RESIDENTIAL MENTAL HEALTH

Certificate Type: Waiver
NPI Number: 1245309749

Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

CLIA Record

Field Name Field Value
CLIA Number 16D2161948
LAB Type Other - RESIDENTIAL MENTAL HEALTH
Facility Name VERA FRENCH PINE MEADOWS
Street 4656 W KIMBERLY ROAD
City DAVENPORT
State IA
ZIP 52806
Phone 563 345-6573
CertificateType 4
CertificateEffectiveDate 2/13/2023
CertificateExpirationDate 2/12/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024