| Heartland Recovery Center, Inc. | |
|
2068 Lucas Pkwy Lowell IN 46356-2169 | |
| (219) 690-7025 | |
| Not Available |
| Full Name | Heartland Recovery Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2068 Lucas Pkwy, Lowell, Indiana |
| Authorized Official Name and Position | Jaime Rogers (DOO/CEO) |
| Authorized Official Contact | 2196907025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Recovery Center, Inc. 2068 Lucas Pkwy Lowell IN 46356-2169 Ph: (219) 241-3249 | Heartland Recovery Center, Inc. 2068 Lucas Pkwy Lowell IN 46356-2169 Ph: (219) 690-7025 |
| NPI Number | 1417320508 |
|---|---|
| Provider Enumeration Date | 11/11/2015 |
| Last Update Date | 04/23/2026 |
| Certification Date | 04/23/2026 |
| Medicare PECOS PAC ID | 1355687831 |
|---|---|
| Medicare Enrollment ID | O20190104002131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417320508 | NPI | - | NPPES |
| Provider Name | Kaley Michelle Marino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376021725 PECOS PAC ID: 3779834064 Enrollment ID: I20180926000520 |
| Provider Name | Stan Barnard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760870547 PECOS PAC ID: 9638619729 Enrollment ID: I20240904000725 |
| Provider Name | Derek Blagojevic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508507302 PECOS PAC ID: 6204377211 Enrollment ID: I20240918000763 |
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