Heartland Health LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP0620 Issued in MN

Legal business name

HEARTLAND HEALTH LLC

Practice address

6950 France Ave S Ste 14
Edina, MN 55435-2016

Phone

(952) 922-9056

NPI assigned

Nov 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Craig Lyle Polsfuss, MA, MSWNPI 1811993553

Title

Ceo

Phone

(952) 922-9056

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig Polsfuss, MA, LP, MSW

  • Psychologist
  • Apple Valley, MN
  • NPI 1811993553
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228003200000",
    "number": "1043465321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15552 DYNASTY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247836",
            "telephone_number": "952-922-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 FRANCE AVE S STE 14",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352016",
            "telephone_number": "952-922-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-30",
        "last_updated": "2008-11-30",
        "status": "A",
        "authorized_official_last_name": "POLSFUSS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-922-9056",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP0620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013848700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Edina, MN
• Providers in Edina, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.