Organization
HEARTLAND ALTERNATIVE SERVICE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA A. HEAD (EXECUTIVE DIRECTOR)
(573) 686-5488
Entity
Organization
Contact information
Practice address
331 N MAIN ST, POPLAR BLUFF, MO 63901-5154
(573) 686-5488
(573) 686-5488
Mailing address
331 N MAIN ST, POPLAR BLUFF, MO 63901-5154
(573) 686-5488
(573) 686-5488
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
188
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188
SATOP CERTIFICATION #
MO
Enumeration date
03/06/2007
Last updated
04/06/2011
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