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General NPI Number Information
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NPI Number | 1316690191
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Entity Type | Organization
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Legal Business Name | HEARTLAND WELLNESS CENTER
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 2165 KIMBER CT
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City | REDDING
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State | CA
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Zip | 96002-0741
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Country | US
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Telephone | 530-227-7031
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Fax |
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Provider Business Mailing Address
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Address Line | 14440 SEABISCUIT CT
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City | REDDING
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State | CA
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Zip | 96003-9407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MATTHEW GIRI
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Credential |
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Telephone | 530-227-7031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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