MEDICARE: HEART LAND SUPPORTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1083270391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART LAND SUPPORTS, LLC

Provider Business Mailing Address
First Line	:	4822 SW WEST HILLS DR
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66606-2244
Country	:	US
Telephone Number	:	785-608-9090
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 MUSE ST
Second Line	:
City	:	NEWTON
State	:	KS
Zip	:	67114-3829
Country	:	US
Telephone Number	:	316-283-0843
Fax Number	:	316-804-4443

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	BENOIT M SWINNEN
Credential	:
Telephone Number	:	785-608-9090

Provider Enumeration Date	:	05/13/2019
Last Update Date	:	05/13/2019

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