Provider Demographics
NPI:1235132820
Name:SIERRA HEALTH CARE INC
Entity Type:Organization
Organization Name:SIERRA HEALTH CARE INC
Other - Org Name:SIERRA HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JEREMY
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-894-7855
Mailing Address - Street 1:1400 N SILVER ST
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-1957
Mailing Address - Country:US
Mailing Address - Phone:575-894-7855
Mailing Address - Fax:575-894-6438
Practice Address - Street 1:1400 N SILVER ST
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1957
Practice Address - Country:US
Practice Address - Phone:575-894-7855
Practice Address - Fax:575-894-6438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM01178319002313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMI-0555Medicaid
NM325062Medicare Oscar/Certification