Healthcare Provider Details

I. General information

NPI: 1235132820
Provider Name (Legal Business Name): SIERRA HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N SILVER ST
TRUTH OR CONSEQUENCES NM
87901-1957
US

IV. Provider business mailing address

1400 N SILVER ST
TRUTH OR CONSEQUENCES NM
87901-1957
US

V. Phone/Fax

Practice location:
  • Phone: 575-894-7855
  • Fax: 575-894-6438
Mailing address:
  • Phone: 575-894-7855
  • Fax: 575-894-6438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number01178319002
License Number StateNM

VIII. Authorized Official

Name: ROBERT JEREMY MARTIN
Title or Position: PRESIDENT
Credential:
Phone: 575-894-7855