Provider Demographics
NPI:1376677427
Name:SIERRA HEALTH CARE, INC.
Entity Type:Organization
Organization Name:SIERRA HEALTH CARE, INC.
Other - Org Name:SIERRA PERSONAL CARE
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:505-828-0232
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:505-743-1175
Mailing Address - Fax:
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:505-743-1175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM09672320251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM09672320OtherPROVIDER NUMBER
NM73085758OtherDISABLED & ELDERLY WAIVER