Provider Demographics
NPI:1598079386
Name:HEARTLAND HEALTHCARE CENTER OF MOLINE
Entity Type:Organization
Organization Name:HEARTLAND HEALTHCARE CENTER OF MOLINE
Other - Org Name:PROMEDICA SKILLED NURSING AND REHABILITATION (MOLINE)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOOMSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-764-6744
Mailing Address - Street 1:833 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:833 16TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-3808
Practice Address - Country:US
Practice Address - Phone:309-764-6744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCR-MANORCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-04
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0049403314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility