Provider Demographics
NPI:1477534261
Name:HEARTLAND CARE INC.
Entity Type:Organization
Organization Name:HEARTLAND CARE INC.
Other - Org Name:HEARTLAND CONTINUING CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-980-0611
Mailing Address - Street 1:13185 W GREEN MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3512
Mailing Address - Country:US
Mailing Address - Phone:303-980-0611
Mailing Address - Fax:303-986-4043
Practice Address - Street 1:1604 W 18TH ST
Practice Address - Street 2:
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130-7097
Practice Address - Country:US
Practice Address - Phone:505-359-4719
Practice Address - Fax:505-359-4722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5232314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMI-1567Medicaid
NMI-1567Medicaid