Provider Demographics
NPI:1073666954
Name:HEARTLAND AREA EDUCATION AENCY 11
Entity type:Organization
Organization Name:HEARTLAND AREA EDUCATION AENCY 11
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISOND
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:515-270-0405
Mailing Address - Street 1:6500 CORPORATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1603
Mailing Address - Country:US
Mailing Address - Phone:515-270-9030
Mailing Address - Fax:515-270-5383
Practice Address - Street 1:6500 CORPORATE DRIVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1603
Practice Address - Country:US
Practice Address - Phone:515-270-9030
Practice Address - Fax:515-270-5383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
Not Answered163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Multi-Specialty
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, BlindGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0051110Medicaid
IA0279695Medicaid