| Genesis Mental Health Associates Llc | |
|
1218 Central Ave Fort Dodge IA 50501-4246 | |
| (515) 571-4422 | |
| Not Available |
| Full Name | Genesis Mental Health Associates Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1218 Central Ave, Fort Dodge, Iowa |
| Authorized Official Name and Position | Leann Marie Rider-hildreth (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5153327167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Mental Health Associates Llc 1218 Central Ave Fort Dodge IA 50501-4246 Ph: (515) 571-4422 | Genesis Mental Health Associates Llc 1218 Central Ave Fort Dodge IA 50501-4246 Ph: (515) 571-4422 |
| NPI Number | 1588729131 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8123029634 |
|---|---|
| Medicare Enrollment ID | O20070126000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588729131 | NPI | - | NPPES |
| 1245298116 | Other | IA | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 01155 (Iowa) | Primary |
| Provider Name | Leann M Rider-hildreth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245298116 PECOS PAC ID: 6406958917 Enrollment ID: I20070306000026 |
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