Provider Demographics
NPI:1942361084
Name:HILLCREST FAMILY SERVICES
Entity Type:Organization
Organization Name:HILLCREST FAMILY SERVICES
Other - Org Name:HILLCREST MENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURGMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-582-0145
Mailing Address - Street 1:200 MERCY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7303
Mailing Address - Country:US
Mailing Address - Phone:563-582-0145
Mailing Address - Fax:563-582-0722
Practice Address - Street 1:200 MERCY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7303
Practice Address - Country:US
Practice Address - Phone:563-582-0145
Practice Address - Fax:563-582-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06232104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty