Provider Demographics
NPI:1568116135
Name:HILLS AND DALES CHILD DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:HILLS AND DALES CHILD DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:MESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-556-7878
Mailing Address - Street 1:1011 DAVIS STREET
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-1397
Mailing Address - Country:US
Mailing Address - Phone:563-556-7878
Mailing Address - Fax:563-557-3822
Practice Address - Street 1:3505 STONEMAN ROAD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002
Practice Address - Country:US
Practice Address - Phone:563-585-0560
Practice Address - Fax:563-556-1259
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLS AND DALES CHILD DEVELOPMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-11
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0880260Medicaid