Provider Demographics
NPI:1962678045
Name:ABBE CENTER FOR CMH AT JONES COUNTY
Entity Type:Organization
Organization Name:ABBE CENTER FOR CMH AT JONES COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAESTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:319-398-3562
Mailing Address - Street 1:520 11TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-3811
Mailing Address - Country:US
Mailing Address - Phone:319-398-3562
Mailing Address - Fax:319-398-3501
Practice Address - Street 1:405 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANAMOSA
Practice Address - State:IA
Practice Address - Zip Code:52205-1866
Practice Address - Country:US
Practice Address - Phone:319-398-3562
Practice Address - Fax:319-398-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0074575Medicaid