Provider Demographics
NPI:1003122334
Name:HERITAGE ADULT DAY INC
Entity Type:Organization
Organization Name:HERITAGE ADULT DAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIDDINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-886-1670
Mailing Address - Street 1:741 W 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46407-3524
Mailing Address - Country:US
Mailing Address - Phone:219-886-1670
Mailing Address - Fax:219-886-1670
Practice Address - Street 1:741 W 25TH AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46407-3524
Practice Address - Country:US
Practice Address - Phone:219-886-1670
Practice Address - Fax:219-886-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
IN320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness