Provider Demographics
NPI:1629471990
Name:HEARTLAND HOSPICE AND HOME HEALTH LLC
Entity Type:Organization
Organization Name:HEARTLAND HOSPICE AND HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-663-8088
Mailing Address - Street 1:109 W BENTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-2948
Mailing Address - Country:US
Mailing Address - Phone:830-663-8088
Mailing Address - Fax:844-374-9968
Practice Address - Street 1:109 W BENTON AVE STE B
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-2948
Practice Address - Country:US
Practice Address - Phone:830-663-8088
Practice Address - Fax:844-374-9968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X, 251F00000X
TX016576251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based