Provider Demographics
NPI:1841570058
Name:HEARTLAND HEALTHCARE CENTER LLC
Entity type:Organization
Organization Name:HEARTLAND HEALTHCARE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-736-9581
Mailing Address - Street 1:901 SUNCOOK VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:EPSOM
Mailing Address - State:NH
Mailing Address - Zip Code:03234-4329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 SUNCOOK VALLEY HWY
Practice Address - Street 2:
Practice Address - City:EPSOM
Practice Address - State:NH
Practice Address - Zip Code:03234-4329
Practice Address - Country:US
Practice Address - Phone:603-736-4772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
305080Medicare Oscar/Certification