NPIMap

Organization Active NPI

Heartland Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Effingham, IL
National Provider Identifier
1376543520
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04068 Issued in IL
Legal business name
HEARTLAND HUMAN SERVICES
Practice address
1200 N 4TH St
Effingham, IL 62401-3032
Phone
(217) 347-7179
Fax
(217) 342-6716
NPI assigned
Jul 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Authorized official

Name
Shannon Quandt
Title
Executive Director
Phone
(217) 347-7179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04068 IL Primary

Addresses

Primary practice location

1200 N 4TH St
Effingham, IL 62401-3032

Mailing address

1200 N 4TH St
PO Box 1047
Effingham, IL 62401-3032
Phone (217) 347-7179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080825000128 IL Part B Supplier - Clinic/Group Practice 7719052851 Receives reassigned benefits from 2 practitioners
Practice locations: Effingham, IL

National Provider Directory

National Provider Directory
Tax ID family
Heartland Human Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1200 N 4th St
#1047
Effingham, IL 62401

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1376543520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N 4TH ST",
            "address_2": "PO BOX 1047",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013032",
            "telephone_number": "217-347-7179",
            "fax_number": "217-342-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N 4TH ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013032",
            "telephone_number": "217-347-7179",
            "fax_number": "217-342-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "QUANDT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "217-347-7179"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.