Provider Demographics
NPI:1154472348
Name:HEARTLAND HEALTH SERVICES OF KANSAS CITY, INC.
Entity type:Organization
Organization Name:HEARTLAND HEALTH SERVICES OF KANSAS CITY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUSTAEDTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-931-3215
Mailing Address - Street 1:3215 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2645
Mailing Address - Country:US
Mailing Address - Phone:816-931-3215
Mailing Address - Fax:816-931-3217
Practice Address - Street 1:3215 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2645
Practice Address - Country:US
Practice Address - Phone:816-931-3215
Practice Address - Fax:816-931-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO100941041C0700X, 225100000X, 225X00000X, 2278P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered2278P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO264535Medicare ID - Type Unspecified