Organization
HEARTLAND BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA J GOODMAN APRN, FNP, PMHNP-BC (OWNER)
(270) 242-1131
Entity
Organization
Contact information
Practice address
112 PEONIA RD, CLARKSON, KY 42726-8049
(270) 734-0512
Mailing address
112 PEONIA RD, CLARKSON, KY 42726-8049
(270) 734-0512
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100657790
—
KY
Enumeration date
01/21/2020
Last updated
04/28/2020
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