| Grace C Mae Advocate Center, Inc | |
|
260 33rd Ave Sw Ste J Cedar Rapids IA 52404-4646 | |
| (319) 361-6529 | |
| (319) 343-1059 |
| Full Name | Grace C Mae Advocate Center, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 260 33rd Ave Sw Ste J, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Patricia Carolyn Gilbaugh (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3193616529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace C Mae Advocate Center, Inc 260 33rd Ave Sw Ste J Cedar Rapids IA 52404-4646 Ph: (319) 361-6529 | Grace C Mae Advocate Center, Inc 260 33rd Ave Sw Ste J Cedar Rapids IA 52404-4646 Ph: (319) 361-6529 |
| NPI Number | 1700018405 |
|---|---|
| Provider Enumeration Date | 08/13/2009 |
| Last Update Date | 12/01/2021 |
| Certification Date | 12/01/2021 |
| Medicare PECOS PAC ID | 2668504549 |
|---|---|
| Medicare Enrollment ID | O20100712000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700018405 | NPI | - | NPPES |
| 600613389 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 251V00000X | Voluntary Or Charitable | (* (Not Available)) | Secondary |
| Provider Name | Patricia Carolyn Gilbaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326205121 PECOS PAC ID: 9638201510 Enrollment ID: I20100716000697 |
| Provider Name | Samantha Agan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598210114 PECOS PAC ID: 2860888906 Enrollment ID: I20220330000207 |
| Provider Name | Abigail A Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932756392 PECOS PAC ID: 5698134633 Enrollment ID: I20230707003642 |
| Provider Name | Melissa A Kress |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710547849 PECOS PAC ID: 0547610792 Enrollment ID: I20231229001486 |
| Provider Name | Jamie L Rich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386275337 PECOS PAC ID: 6800246885 Enrollment ID: I20240103002883 |
| Provider Name | Melissa A Bass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265199533 PECOS PAC ID: 6507216595 Enrollment ID: I20240103003022 |
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