Provider Demographics
NPI:1083759088
Name:HERITAGE HOME CARE, INC.
Entity Type:Organization
Organization Name:HERITAGE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-481-9100
Mailing Address - Street 1:1159 E MICHIGAN AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5807
Mailing Address - Country:US
Mailing Address - Phone:734-481-9100
Mailing Address - Fax:734-481-9200
Practice Address - Street 1:1159 E MICHIGAN AVE
Practice Address - Street 2:SUITE G
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5807
Practice Address - Country:US
Practice Address - Phone:734-481-9100
Practice Address - Fax:734-481-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237501Medicare ID - Type Unspecified