Healthcare Provider Details

I. General information

NPI: 1700055860
Provider Name (Legal Business Name): HEARTLAND HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 4TH AVE STE 18
KEARNEY NE
68845
US

IV. Provider business mailing address

4111 4TH AVE STE 18
KEARNEY NE
68845
US

V. Phone/Fax

Practice location:
  • Phone: 308-234-4663
  • Fax: 308-234-4668
Mailing address:
  • Phone: 308-234-4663
  • Fax: 308-234-4668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA1041
License Number StateNE

VIII. Authorized Official

Name: JENIFER R HOVLAND
Title or Position: OFFICE MANAGER/ AUTHORIZED AGENT
Credential:
Phone: 605-624-5900