NPIMap

Organization Active NPI

Hillcrest Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dubuque, IA
National Provider Identifier
1851645675
Registry record updated Oct 31, 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
HILLCREST FAMILY SERVICES
Practice address
225 W 6TH St
Dubuque, IA 52001-6809
Phone
(563) 690-1239
NPI assigned
Oct 31, 2012
Last updated
Oct 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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

225 W 6TH St
Dubuque, IA 52001-6809

Mailing address

225 W 6TH St
Dubuque, IA 52001-2375
Phone (563) 690-1239

Other identifiers 2

IdentifierTypeStateIssuer
0488775MedicaidIA
11492OtherIAWELLMARK BCBS

National Provider Directory

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

Other organizations with this tax ID 21

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

View all 21

Locations

225 W 6th St
Dubuque, IA 52001
Phone (563) 588-0605

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1851645675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W 6TH ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520012375",
            "telephone_number": "563-690-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W 6TH ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016809",
            "telephone_number": "563-690-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "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": "WELLMARK BCBS",
            "identifier": "11492",
            "state": "IA"
        }
    ],
    "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 Oct 31, 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.