Healthcare Provider Details

I. General information

NPI: 1750285862
Provider Name (Legal Business Name): BRIDGECREST AT DUBUQUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 SEIPPEL RD
DUBUQUE IA
52002-9788
US

IV. Provider business mailing address

1160 SEIPPEL RD
DUBUQUE IA
52002-9788
US

V. Phone/Fax

Practice location:
  • Phone: 563-291-7770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAY HALON
Title or Position: MR
Credential:
Phone: 848-525-8697