MEDICARE: HEARTLAND COMMUNITIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1588324800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND COMMUNITIES INC

Provider Business Mailing Address
First Line	:	1703 HOWELL ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46808-2519
Country	:	US
Telephone Number	:	425-213-7516
Fax Number	:	260-420-6199

Provider Business Practice Location Address
First Line	:	1703 HOWELL ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46808-2519
Country	:	US
Telephone Number	:	425-213-7516
Fax Number	:	260-420-6199

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JAIN YOUNG
Credential	:	MA
Telephone Number	:	425-213-7516

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	12/28/2021

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Directions to “HEARTLAND COMMUNITIES INC ” Practice Location

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