Provider Demographics
NPI:1457436586
Name:REGION II HUMAN SERVICES
Entity Type:Organization
Organization Name:REGION II HUMAN SERVICES
Other - Org Name:HEARTLAND COUNSELING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:308-534-0440
Mailing Address - Street 1:401 WEST 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153
Mailing Address - Country:US
Mailing Address - Phone:308-284-6767
Mailing Address - Fax:308-284-3084
Practice Address - Street 1:401 WEST 1ST STREET
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153
Practice Address - Country:US
Practice Address - Phone:308-284-6767
Practice Address - Fax:308-284-3084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
0B6570OtherRAILROAD MEDICARE
NE01822OtherBCBS
070450OtherTRICARE
0B6570OtherRAILROAD MEDICARE
092511Medicare ID - Type Unspecified