Healthcare Provider Details

I. General information

NPI: 1710958632
Provider Name (Legal Business Name): HILLS AND DALES CHILD DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 DAVIS ST
DUBUQUE IA
52001-1306
US

IV. Provider business mailing address

1011 DAVIS ST
DUBUQUE IA
52001-1306
US

V. Phone/Fax

Practice location:
  • Phone: 563-556-7878
  • Fax: 563-557-3822
Mailing address:
  • Phone: 563-556-7878
  • Fax: 563-557-3822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number310131
License Number StateIA

VIII. Authorized Official

Name: JACK MESCHER
Title or Position: CEO
Credential:
Phone: 563-556-7878