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NPI Code Detail

MEDICARE: ABBE CENTER FOR CMH AT ASAC

MEDICARE: ABBE CENTER FOR CMH AT ASAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225204308
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABBE CENTER FOR CMH AT ASAC
Provider Business Mailing Address
First Line : 520 11TH ST NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-3811
Country : US
Telephone Number : 319-398-3562
Fax Number : 319-398-3501
Provider Business Practice Location Address
First Line : 3601 16TH AVE SW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52404-2328
Country : US
Telephone Number : 319-398-3562
Fax Number : 319-398-3501
Authorized Official
Title or Position : DIRECTOR
Name : CINDY KAESTNER
Credential : LISW
Telephone Number : 319-398-3562
Provider Enumeration Date : 05/07/2008
Last Update Date : 05/07/2008

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52404-2328
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1114138724 — MS. INGRID DAWN MEYER M.A.
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1487150660 — GAYLE HENDRICKS MS, LMHC, LCPC, CADC
Practice Location Address:
3601 16TH AVE SW
CEDAR RAPIDS, IA
52404-2328
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Practice Fax:
1871080069 — DEB SCHULTEJANS
Practice Location Address:
3601 16TH AVE SW
CEDAR RAPIDS, IA
52404-2328
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1225527591 — CARIE JO THOMSEN GORDON BA, IADC
Practice Location Address:
3601 16TH AVE SW
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Directions to “ABBE CENTER FOR CMH AT ASAC ” Practice Location

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