Provider Demographics
NPI:1972248847
Name:HEARTLAND HEALTH GROUP CORP
Entity type:Organization
Organization Name:HEARTLAND HEALTH GROUP CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-906-0505
Mailing Address - Street 1:2670 CHANDLER AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-4084
Mailing Address - Country:US
Mailing Address - Phone:240-317-7224
Mailing Address - Fax:
Practice Address - Street 1:2670 CHANDLER AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4084
Practice Address - Country:US
Practice Address - Phone:240-317-7224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1972248847OtherMEDICARE PART B
NV1972248847OtherMEDICARE PART A
MD1972248847OtherMEDICARE PART A
MD1972248847OtherMEDICARE PART B