NPIMap

Organization Active NPI

Heartland Family Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Council Bluffs, IA
National Provider Identifier
1316009475
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HEARTLAND FAMILY SERVICE
Practice address
515 E Broadway
Council Bluffs, IA 51503
Phone
(712) 322-1407
Fax
(712) 322-6833
NPI assigned
Dec 15, 2006
Last updated
Sep 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Authorized official

Name
John Jeanetta, MBA, MSW
Title
President Ceo
Phone
(402) 552-7402

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NE Primary
Adult Mental Health Clinic/Center 261QM0850X NE
Adolescent and Children Mental Health Clinic/Center 261QM0855X NE

Addresses

Primary practice location

515 E Broadway
Council Bluffs, IA 51503

Mailing address

2101 S 42ND St
Omaha, NE 68105-2909
Phone (402) 553-3000

Other names 1

  • Family Service Former legal business name

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.

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

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1316009475",
    "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": "681052909",
            "telephone_number": "402-553-3000",
            "fax_number": "402-553-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51503",
            "telephone_number": "712-322-1407",
            "fax_number": "712-322-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND FAMILY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2010-09-01",
        "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",
        "authorized_official_credential": "MBA, MSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NE",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NE",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Service",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.