NPIMap

Organization Active NPI

Heartland Family Service

  • Addiction (Substance Use Disorder) Counselor
  • Council Bluffs, IA
National Provider Identifier
1063647311
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
HEARTLAND FAMILY SERVICE
Practice address
1722 Ave C
Council Bluffs, IA 51501-2440
Phone
(712) 435-5380
NPI assigned
May 15, 2009
Last updated
Aug 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
John Jeanetta
Title
President / Ceo
Phone
(402) 552-7402

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary
Mental Health Counselor 101YM0800X NU

Addresses

Primary practice location

1722 Ave C
Council Bluffs, IA 51501-2440

Mailing address

2101 S 42ND St
Omaha, NE 68105-2947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081218000069 IA Part B Supplier - Clinic/Group Practice 7315833506 Receives reassigned benefits from 29 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Logan, IA; Harlan, IA; Glenwood, IA; Council Bluffs, IA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2180069Heartland Family Service Iowa Family Works1722 Ave C, Council Bluffs, IA 51501Certificate of waiverMar 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Family Service21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

1722 Avenue C
Council Bluffs, IA 51501
Phone (712) 435-5380

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1063647311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S 42ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681052947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 AVE C",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515012440",
            "telephone_number": "712-435-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND FAMILY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "JEANETTA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "402-552-7402"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.