Healthcare Provider Details

I. General information

NPI: 1588578256
Provider Name (Legal Business Name): HEARTLAND FAMILY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 OLIVE ST
ATLANTIC IA
50022-1935
US

IV. Provider business mailing address

2307 OLIVE ST PO BOX 34
ATLANTIC IA
50022-1935
US

V. Phone/Fax

Practice location:
  • Phone: 712-243-5091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DIANA ROBERTS
Title or Position: INTAKE PD
Credential:
Phone: 402-552-7459