Organization
HEARTLAND HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON QUANDT (EXECUTIVE DIRECTOR)
(217) 347-7179
Entity
Organization
Contact information
Practice address
1116 N WENTHE DR, UNIT B, EFFINGHAM, IL 62401-1635
(217) 347-7179
(217) 342-6716
Mailing address
1200 N 4TH ST, PO BOX 1047, EFFINGHAM, IL 62401-3032
(217) 347-7179
(217) 342-6716
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
91S064
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ITIN019
—
IL
Enumeration date
08/07/2008
Last updated
11/29/2018
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