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Organization
HFS ASBURY WEST CMHC
Active
Organization
HFS ASBURY WEST CMHC
Active
Parent organization
HILLCREST FAMILY SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
HILLCREST FAMILY SERVICES
Authorized official
GARY GANSEMER (CEO)
(563) 583-7357
Entity
Organization
Contact information
Practice address
2728 ASBURY RD, DUBUQUE, IA 52001-2971
(563) 875-0769
Mailing address
2728 ASBURY RD, DUBUQUE, IA 52001-2971
(563) 875-0769
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488775
—
IA
01
—
11492
BCBS
ID
Enumeration date
11/28/2012
Last updated
11/28/2012
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