Provider Demographics
NPI:1588324800
Name:HEARTLAND COMMUNITIES INC
Entity type:Organization
Organization Name:HEARTLAND COMMUNITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:425-213-7516
Mailing Address - Street 1:1703 HOWELL ST
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46808-2519
Mailing Address - Country:US
Mailing Address - Phone:425-213-7516
Mailing Address - Fax:260-420-6199
Practice Address - Street 1:1703 HOWELL ST
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46808-2519
Practice Address - Country:US
Practice Address - Phone:425-213-7516
Practice Address - Fax:260-420-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals