MEDICARE: HILLCREST FAMILY SERVICES

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1245652577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLCREST FAMILY SERVICES

Provider Business Mailing Address
First Line	:	106 N JACKSON ST
Second Line	:
City	:	MT PLEASANT
State	:	IA
Zip	:	52641-2047
Country	:	US
Telephone Number	:	319-385-7177
Fax Number	:	319-385-9567

Provider Business Practice Location Address
First Line	:	106 N JACKSON ST
Second Line	:
City	:	MT PLEASANT
State	:	IA
Zip	:	52641-2047
Country	:	US
Telephone Number	:	319-385-7177
Fax Number	:	319-385-9567

Authorized Official
Title or Position	:	CEO
Name	:	MR. GARY GANSEMER
Credential	:
Telephone Number	:	563-583-7357

Provider Enumeration Date	:	01/06/2014
Last Update Date	:	04/29/2014

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Directions to “HILLCREST FAMILY SERVICES ” Practice Location

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