| Heart Of Play Llc | |
|
1721 Elmhurst Ave Humboldt IA 50548-1882 | |
| (515) 450-2583 | |
| (515) 420-8303 |
| Full Name | Heart Of Play Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1721 Elmhurst Ave, Humboldt, Iowa |
| Authorized Official Name and Position | Nolan M Vitzthum (OWNER/THERAPIST) |
| Authorized Official Contact | 5154502583 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Of Play Llc 1721 Elmhurst Ave Humboldt IA 50548-1882 Ph: (515) 450-2583 | Heart Of Play Llc 1721 Elmhurst Ave Humboldt IA 50548-1882 Ph: (515) 450-2583 |
| NPI Number | 1396575569 |
|---|---|
| Provider Enumeration Date | 08/03/2024 |
| Last Update Date | 11/07/2024 |
| Certification Date | 11/07/2024 |
| Medicare PECOS PAC ID | 5799219283 |
|---|---|
| Medicare Enrollment ID | O20241106001498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396575569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nolan M Vitzthum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003265067 PECOS PAC ID: 5799022737 Enrollment ID: I20210420000529 |
Humboldt County Memorial Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1000 15th St N, Humboldt, IA 50548 Phone: 515-332-4200 Fax: 515-332-4820 | |
Sail Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 724 Sumner Ave, Humboldt, IA 50548 Phone: 712-660-0575 | |