Provider Demographics
NPI:1518534502
Name:HEARTLAND CHARTER SCHOOL
Entity Type:Organization
Organization Name:HEARTLAND CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALED ADMIN
Authorized Official - Phone:707-759-0289
Mailing Address - Street 1:237 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4905
Mailing Address - Country:US
Mailing Address - Phone:707-564-6086
Mailing Address - Fax:
Practice Address - Street 1:955 STANISLAUS ST
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:CA
Practice Address - Zip Code:93252-9779
Practice Address - Country:US
Practice Address - Phone:661-829-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)