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General NPI Number Information
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NPI Number | 1770817447
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Entity Type | Organization
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Legal Business Name | HEARTLAND CARE INC.
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 1402 W GILCHRIST AVE
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City | ARTESIA
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State | NM
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Zip | 88210-1134
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Country | US
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Telephone | 575-359-4726
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Fax | 575-359-4722
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Provider Business Mailing Address
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Address Line | 1604 W 18TH ST
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City | PORTALES
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State | NM
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Zip | 88130-7097
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Country | US
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Telephone | 575-359-4726
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Fax | 575-359-4722
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. RANELLE TWEEDY
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Credential | NHA
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Telephone | 575-359-4726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | PENDING
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License Number State | NM
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