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Organization
HEARTLAND FAMILY SERVICE
Active
Organization
HEARTLAND FAMILY SERVICE
Active
Other names
Family Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JEANETTA MBA, MSW (PRESIDENT/CEO)
(402) 552-7402
Entity
Organization
Contact information
Practice address
2101 S 42ND ST, OMAHA, NE 68105-2947
(402) 553-3000
(402) 553-3133
Mailing address
2101 S 42ND ST, OMAHA, NE 68105
(402) 553-3000
(402) 553-3133
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086011
MEDICARE ID-TYE UNSPECIFI
NE
Enumeration date
08/23/2005
Last updated
09/01/2010
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