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General NPI Number Information
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NPI Number | 1700327426
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Entity Type | Organization
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Legal Business Name | HEARTLAND HEALTHY HEADS NORTH
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 6 VICTORY LN STE 5
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City | LIBERTY
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State | MO
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Zip | 64068-3805
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Country | US
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Telephone | 816-533-5336
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Fax |
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Provider Business Mailing Address
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Address Line | 801 N MUR LEN RD STE 105
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City | OLATHE
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State | KS
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Zip | 66062-1794
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Country | US
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Telephone | 913-730-6487
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHERIE MARIE PARKER
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Credential | RN
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Telephone | 816-533-5336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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