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General NPI Number Information
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NPI Number | 1992297584
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Entity Type | Organization
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Legal Business Name | HEARTLAND FAMILY SERVICE
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 600 9TH AVE
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-6469
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Country | US
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Telephone | 712-325-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 S 42ND ST
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City | OMAHA
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State | NE
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Zip | 68105-2909
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Country | US
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Telephone | 402-553-3000
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Fax |
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Authorized Official
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Title or Position | INTAKE AND BH SYSTEMS COORD
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Name | DIANA ROBERTS
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Credential |
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Telephone | 402-552-7459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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