Basic Information
| Provider Information | |||||||||
| NPI: | 1750616652 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABBE CENTER FOR COMMUNITY MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 11TH ST NW | ||||||||
| Address2: | 520 11TH ST NW | ||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 52405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193983562 | ||||||||
| FaxNumber: | 3193983501 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 11TH ST NW | ||||||||
| Address2: | 520 11TH ST NW | ||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524053811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193983562 | ||||||||
| FaxNumber: | 3193983501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2009 | ||||||||
| LastUpdateDate: | 10/09/2009 | ||||||||
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| AuthorizedOfficialLastName: | BOOTH | ||||||||
| AuthorizedOfficialFirstName: | MARLENE | ||||||||
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| AuthorizedOfficialTitleorPosition: | INTAKE | ||||||||
| AuthorizedOfficialTelephone: | 3193983562 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 089387 | IA | Y | Agencies | Community/Behavioral Health |
No ID Information.