Healthcare Provider Details

I. General information

NPI: 1184693665
Provider Name (Legal Business Name): SIERRA HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N CHURCH ST STE 300
LAS CRUCES NM
88001-3548
US

IV. Provider business mailing address

PO BOX 91000
ALBUQUERQUE NM
87199-1000
US

V. Phone/Fax

Practice location:
  • Phone: 575-219-6055
  • Fax:
Mailing address:
  • Phone: 575-219-6055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3088
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number3158
License Number StateNM

VIII. Authorized Official

Name: ROBERT J MARTIN
Title or Position: PRESIDENT
Credential:
Phone: 575-219-6055