# HEARTLAND BEHAVIORAL HEALTH LLC

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

## Provider details

- **NPI number:** 1295365054
- **Authorized official:** DONNA J GOODMAN APRN, FNP, PMHNP-BC (OWNER)
- **Authorized official phone:** (270) 242-1131

## Contact information

- **Practice address:** 112 PEONIA RD, CLARKSON, KY 42726-8049
- **Practice address phone:** (270) 734-0512
- **Mailing address:** 112 PEONIA RD, CLARKSON, KY 42726-8049
- **Mailing address phone:** (270) 734-0512

## 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:** 01/21/2020
- **Last updated:** 04/28/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100657790 | — | KY |