NPIMap

Organization Active NPI

Grace C Mae Advocate Center

  • Community/Behavioral Health Agency
  • Washington, IA
National Provider Identifier
1265879431
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
008087 Issued in IA
Legal business name
GRACE C MAE ADVOCATE CENTER
Practice address
420 E Polk St
Washington, IA 52353-1237
Phone
(319) 653-3930
NPI assigned
May 29, 2013
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Patricia C Gilbaugh, LISW, PHD
Title
Executive Director/Therapist
Phone
(319) 361-6529

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Grace C Mae Advocate Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 008087 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

420 E Polk St
Washington, IA 52353-1237

Mailing address

PO Box 4
Van Horne, IA 52346-0004
Phone (319) 361-6529

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0101342MedicaidIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 29, 2013.

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1265879431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "VAN HORNE",
            "state": "IA",
            "postal_code": "523460004",
            "telephone_number": "319-361-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E POLK ST",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523531237",
            "telephone_number": "319-653-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE C MAE ADVOCATE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "GILBAUGH",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/THERAPIST",
        "authorized_official_telephone_number": "319-361-6529",
        "authorized_official_credential": "LISW, PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": "008087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101342",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.