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General NPI Number Information
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NPI Number | 1639496128
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Entity Type | Organization
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Legal Business Name | HEARTLAND SOCIAL WORK STAFFING, LLC
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 1648 R B BAKER LN
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City | VALLEY MILLS
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State | TX
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Zip | 76689-2640
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Country | US
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Telephone | 208-989-0175
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Fax | 254-836-1446
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | CHINA SPRING
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State | TX
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Zip | 76633-0160
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Country | US
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Telephone | 208-989-0175
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Fax | 254-836-1446
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Authorized Official
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Title or Position | MANAGING MEMEBER
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Name | MR. JD RAY HOAGLAND
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Credential |
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Telephone | 208-989-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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