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General NPI Number Information
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NPI Number | 1497095046
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Entity Type | Organization
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Legal Business Name | HILLCREST FAMILY SERVICES
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 13034 SEIPPEL RD
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City | DUBUQUE
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State | IA
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Zip | 52002-9687
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Country | US
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Telephone | 563-583-1791
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Fax | 563-583-1794
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Provider Business Mailing Address
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Address Line | 2005 ASBURY RD
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City | DUBUQUE
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State | IA
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Zip | 52001-3042
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Country | US
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Telephone | 563-583-7357
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Fax | 888-243-3455
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. GARY GANSEMER
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Credential | MSW
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Telephone | 563-583-7357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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