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General NPI Number Information
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NPI Number | 1457052748
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Entity Type | Organization
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Legal Business Name | HEARTLAND HAVEN
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 1345 CHEROKEE RD
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City | INMAN
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State | KS
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Zip | 67546-8086
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Country | US
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Telephone | 620-585-6908
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Fax | 620-585-6930
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Provider Business Mailing Address
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Address Line | 1345 CHEROKEE RD
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City | INMAN
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State | KS
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Zip | 67546-8086
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Country | US
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Telephone | 620-585-6908
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Fax | 620-585-6930
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Authorized Official
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Title or Position | OPERATOR
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Name | SABRINA M BADGETT
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Credential | REGISTERED NURSE
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Telephone | 620-585-6908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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