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Organization
HEARTLAND PEDIATRIC FEEDING DISORDERS SERVICES
Active
Organization
HEARTLAND PEDIATRIC FEEDING DISORDERS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN DAVID CASEY PH.D., BCBA (CLINICAL DIRECTOR)
(515) 771-6248
Entity
Organization
Contact information
Practice address
121 HORSESHOE DR, MONTEZUMA, IA 50171-8416
(515) 771-6248
Mailing address
121 HORSESHOE DR, MONTEZUMA, IA 50171-8416
(515) 771-6248
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
10/20/2015
Last updated
11/18/2015
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