# HEARTLAND HEALTHCARE PSYCHIATRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174139950
- **Authorized official:** DR. ROBERT WILLIAM DETLEFSEN DNP, FPMH-NP, B.C. (DR. ROBERT DETLEFSEN, DNP)
- **Authorized official phone:** (319) 471-2479

## Contact information

- **Practice address:** 455 N ORTHMCKENZIE LANE, NORTH LIBERTY, IA 52317-8901
- **Practice address phone:** (319) 471-2479
- **Practice address fax:** (877) 756-4974
- **Mailing address:** 455 N ORTHMCKENZIE LANE, NORTH LIBERTY, IA 52317-8901
- **Mailing address phone:** (319) 471-2479
- **Mailing address fax:** (877) 756-4974

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2020
- **Last updated:** 09/17/2020