Healthcare Provider Details

I. General information

NPI: 1497295810
Provider Name (Legal Business Name): HEARTLAND HABILITAIVE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2017
Last Update Date: 03/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 CROSS HILL RD STE 300B
COLUMBIA SC
29205-2084
US

IV. Provider business mailing address

702 CROSS HILL RD STE 300B
COLUMBIA SC
29205-2084
US

V. Phone/Fax

Practice location:
  • Phone: 402-853-4332
  • Fax:
Mailing address:
  • Phone: 402-853-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ARTHUR WADE SCOTT
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 402-853-4332