Provider Demographics
NPI:1497295810
Name:HEARTLAND HABILITAIVE SERVICES, LLC
Entity Type:Organization
Organization Name:HEARTLAND HABILITAIVE SERVICES, LLC
Other - Org Name:HEARTLAND HABILITAIVE SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-853-4332
Mailing Address - Street 1:702 CROSS HILL RD STE 300B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2084
Mailing Address - Country:US
Mailing Address - Phone:402-853-4332
Mailing Address - Fax:
Practice Address - Street 1:702 CROSS HILL RD STE 300B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2084
Practice Address - Country:US
Practice Address - Phone:402-853-4332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-04
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health