Healthcare Provider Details

I. General information

NPI: 1235305319
Provider Name (Legal Business Name): ABBE CENTER FOR CMH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 12TH ST STE A
BELLE PLAINE IA
52208-1708
US

IV. Provider business mailing address

520 11TH ST NW
CEDAR RAPIDS IA
52405-3811
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-3562
  • Fax: 319-398-3501
Mailing address:
  • Phone: 319-398-3562
  • Fax: 319-398-3501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CINDY KAESTNER
Title or Position: DIRECTOR
Credential: LISW
Phone: 319-398-3562