Active NPI
Heartland-Knollview Mi LLC
- Skilled Nursing Facility
- Muskegon, MI
National Provider Identifier
1679514970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 614050
- Legal business name
- HEARTLAND-KNOLLVIEW MI LLC
- Practice address
- 1061 W Hackley Ave
Muskegon, MI 49441-3059 - Phone
- (231) 755-2255
- Fax
- (231) 759-7612
- NPI assigned
- Jun 9, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Martin D Allen
- Title
- Director
- Phone
- (419) 252-5734
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 614050 | MI | Primary |
Addresses
Primary practice location
1061 W Hackley Ave
Muskegon, MI 49441-3059
Mailing address
333 N Summit St
Toledo, OH 43604-2615
Phone (419) 252-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 605262651 | Medicaid | MI |
Other names 1
- Heartland Health Care Center - Knollview
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1495497600000",
"number": "1679514970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N SUMMIT ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436042615",
"telephone_number": "419-252-5500",
"fax_number": "877-385-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 W HACKLEY AVE",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494413059",
"telephone_number": "231-755-2255",
"fax_number": "231-759-7612"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEARTLAND-KNOLLVIEW MI LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-09",
"last_updated": "2017-05-23",
"status": "A",
"authorized_official_last_name": "ALLEN",
"authorized_official_first_name": "MARTIN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "419-252-5734",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"license": "614050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "605262651",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Heartland Health Care Center - Knollview",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.