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General NPI Number Information
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NPI Number | 1477983963
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Entity Type | Organization
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Legal Business Name | HEARTLAND REGISTRY, INC.
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 238 N BRIDGE ST
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City | LABELLE
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State | FL
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Zip | 33935-5090
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Country | US
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Telephone | 863-675-1231
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Fax | 863-675-1120
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Provider Business Mailing Address
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Address Line | PO BOX 2737
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City | LABELLE
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State | FL
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Zip | 33975-2737
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Country | US
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Telephone | 863-675-1231
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Fax | 863-675-1120
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Authorized Official
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Title or Position | VP
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Name | ROSE WILLIAMS
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Credential | RN
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Telephone | 863-675-1231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 30211229
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License Number State | FL
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