Provider Demographics
NPI:1033449772
Name:HERITAGE SENIOR CARE INC
Entity Type:Organization
Organization Name:HERITAGE SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MAYBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-729-5671
Mailing Address - Street 1:2885 HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1833
Mailing Address - Country:US
Mailing Address - Phone:760-720-7740
Mailing Address - Fax:760-720-7744
Practice Address - Street 1:2885 HOPE AVE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1833
Practice Address - Country:US
Practice Address - Phone:760-720-7740
Practice Address - Fax:760-720-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care