NPIMap

Organization Active NPI

HFS Asbury West CMHC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dubuque, IA
National Provider Identifier
1831434109
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HFS ASBURY WEST CMHC
Practice address
2728 Asbury Rd
Dubuque, IA 52001-2971
Phone
(563) 875-0769
NPI assigned
Nov 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
HILLCREST FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gary Gansemer
Title
Ceo
Phone
(563) 583-7357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

2728 Asbury Rd
Dubuque, IA 52001-2971

Mailing address

2728 Asbury Rd
Dubuque, IA 52001-2971
Phone (563) 875-0769

Other identifiers 2

IdentifierTypeStateIssuer
0488775MedicaidIA
11492OtherIDBCBS

National Provider Directory

National Provider Directory
Tax ID family
Kristine M Staheli Jackson22 organizations share this tax ID, including this one
Part of
Kristine M Staheli Jackson

Other organizations with this tax ID 21

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

View all 21

Locations

2728 Asbury Rd
Dubuque, IA 52001
Phone (563) 556-9642

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1831434109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 ASBURY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520012971",
            "telephone_number": "563-875-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 ASBURY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520012971",
            "telephone_number": "563-875-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HFS ASBURY WEST CMHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HILLCREST FAMILY SERVICES",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "GANSEMER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-583-7357"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0488775",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11492",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.