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HEARTLAND HEALTH OUTREACH INC NPI 1447727037


NPI Information

NPI: 1447727037
Provider Name: HEARTLAND HEALTH OUTREACH, INC
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization

CLIA Number: 14D2138223

Address:
1015 W LAWRENCE AVE
CHICAGO, IL
ZIP 60640
Phone: (773) 275-2586
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HEARTLAND HEALTH OUTREACH, INC is a case manager care coordinator in Chicago, IL. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. HEARTLAND HEALTH OUTREACH, INC NPI is 1447727037. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1015 W LAWRENCE AVE
CHICAGO, IL
ZIP 60640-017
Phone: (773) 275-2586
Fax: (773) 751-4175

The provider's authorized official is Jimmy Valentin .
The authorized official title is Director, His-b and has the following contact phone number (773) 751-4129.

The CLIA number assigned to this NPI record is 14D2138223 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2018 and was last updated on 11/1/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========002MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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