Hillcrest Family Services
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Dubuque, IA
NPI 1497977763 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1497977763
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- HILLCREST FAMILY SERVICES
- Practice address
- 2505 Wilbricht LN
Dubuque, IA 52001 - Phone
- (563) 582-0145
- NPI assigned
- May 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Katie Hoftender
- Title
- Accounts Receivable
- Phone
- (563) 583-7357
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 21
Practitioners 12
-
Earlene Marie Angell, ARNP
-
Deborah Kay Bahe, ARNP
-
Jessica D Dunne, RN
-
Maggie Frederick, MA
-
Hesper B Nowatzki, DNP, FNP, PMHNP-BC
-
Debra Lynn Kimble, LCSW
-
Janet Platt Raines, ARNP
-
Gerry Lou Sertle, APNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000709 | IA | Part B Supplier - Clinic/Group Practice | 1557274743 |
Receives reassigned benefits from 20 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Dubuque, IA; Maquoketa, IA; Mt Pleasant, IA; Wapello, IA; Washington, IA |
National Provider Directory
- Tax ID family
- Kristine M Staheli Jackson
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
2505 Wilbricht LN
Dubuque, IA 52001
Mailing address
2005 Asbury Rd
Dubuque, IA 52001-3042
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0488775 | Medicaid | IA |
Other providers in Dubuque, IA
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
- Hillcrest Family Services
All providers in Dubuque, IA · Mental Health Clinic/Center (Including Community Mental Health Center) in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.