1811998859 NPI number — ABBE MANAGEMENT CORP

Table of content: (NPI 1811998859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811998859 NPI number — ABBE MANAGEMENT CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABBE MANAGEMENT CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASSOCIATES FOR BEHAVIORAL HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811998859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
740 N 15TH AVE STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIAWATHA
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52233-2384
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-396-1066
Provider Business Mailing Address Fax Number:
319-396-8779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1510 BOYSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIAWATHA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52233-2310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-396-1066
Provider Business Practice Location Address Fax Number:
319-396-8779
Provider Enumeration Date:
08/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KREMER
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
319-396-1066

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10474 . This is a "BCBS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0263897 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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