Provider Demographics
NPI:1699305896
Name:HEARTLAND HEALTH CENTER, INC
Entity type:Organization
Organization Name:HEARTLAND HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSUFKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-382-4297
Mailing Address - Street 1:3307 W CAPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1334
Mailing Address - Country:US
Mailing Address - Phone:308-382-4297
Mailing Address - Fax:
Practice Address - Street 1:104 W SENECA ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:NE
Practice Address - Zip Code:68869-1363
Practice Address - Country:US
Practice Address - Phone:308-382-4297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center