| Organization Name: | HEARTLAND HOMES OF DULUTH LLC |
| NPI Number: | 1013085729 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER LEE KLAAS (OWNER OPERATOR) |
| Mailing Address: | 4712 Peabody St Duluth |
| State: | MN US |
| Postal Code: | 558041520 |
| Phone Number: | 2185253471 |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320800000X |
| License Number: | 10446821AFC |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |