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SUBSTANCE ABUSE SERVICES CENTER

Addiction Substance Use Disorder

Dubuque, Iowa

Provider NPI: 1164402293

Organization Information:
Organization Name:  SUBSTANCE ABUSE SERVICES CENTER
Organization is not Subpart
Authorized Official:  DIANE  THOMAS  EXECUTIVE DIRECTOR  563-9275112

Practice Location:
799 MAIN ST SUITE 270 DUBUQUE, IA 52001 US
Tel: 563-582-3784  Fax: 563-582-4006

Business Mailing Address:
799 MAIN ST SUITE 270 DUBUQUE, IA 52001 US
Tel: 563-582-3784  Fax: 563-582-4006

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
IA1216

Other Provider Identifiers:

IssuerNumberStateType
0177394IN05
WELLMARK BC/BS680204IA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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