Provider Demographics
NPI:1174519532
Name:HEARTLAND CARE CENTER INC
Entity type:Organization
Organization Name:HEARTLAND CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROGGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-376-2500
Mailing Address - Street 1:604 E FENTON ST
Mailing Address - Street 2:
Mailing Address - City:MARCUS
Mailing Address - State:IA
Mailing Address - Zip Code:51035-7170
Mailing Address - Country:US
Mailing Address - Phone:712-376-2500
Mailing Address - Fax:712-376-4445
Practice Address - Street 1:604 E FENTON ST
Practice Address - Street 2:
Practice Address - City:MARCUS
Practice Address - State:IA
Practice Address - Zip Code:51035-7170
Practice Address - Country:US
Practice Address - Phone:712-376-2500
Practice Address - Fax:712-376-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0014310400000X
IA180689314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0809020Medicaid
IA165397Medicare Oscar/Certification