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General NPI Number Information
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NPI Number | 1053587469
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Entity Type | Organization
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Legal Business Name | HEARTLAND CENTER FOR BEHAVIORAL CHANGE
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 1534 CAMPBELL ST
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City | KANSAS CITY
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State | MO
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Zip | 64108-1520
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Country | US
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Telephone | 816-421-6670
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Fax | 816-214-9579
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Provider Business Mailing Address
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Address Line | 1730 PROSPECT AVE. SUITE 100
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City | KANSAS CITY
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State | MO
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Zip | 64127-2573
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Country | US
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Telephone | 816-421-6670
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Fax | 816-214-9558
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. MYRNA TRICKEY
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Credential |
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Telephone | 816-421-6670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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