Organization
HILLCREST FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GANSEMER (CEO)
(563) 583-7357
Entity
Organization
Contact information
Practice address
225 W 6TH ST, DUBUQUE, IA 52001-6809
(563) 690-1239
Mailing address
225 W 6TH ST, DUBUQUE, IA 52001-2375
(563) 690-1239
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
WELLMARK BCBS
IA
Enumeration date
10/31/2012
Last updated
10/31/2012
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