Healthcare Provider Details

I. General information

NPI: 1841593399
Provider Name (Legal Business Name): ST. LUKE'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1077 N CENTER POINT RD
HIAWATHA IA
52233-1231
US

IV. Provider business mailing address

1077 N CENTER POINT RD
HIAWATHA IA
52233-1231
US

V. Phone/Fax

Practice location:
  • Phone: 319-369-7952
  • Fax: 319-368-5643
Mailing address:
  • Phone: 319-369-7952
  • Fax: 319-368-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number006945
License Number StateIA

VIII. Authorized Official

Name: MRS. KIMBERLY ANN STEFFENSMEIER
Title or Position: THERAPIST
Credential: MSW, LISW
Phone: 319-369-8046