Provider Demographics
NPI:1407013030
Name:THE HERITAGE ALF INC.
Entity Type:Organization
Organization Name:THE HERITAGE ALF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MACALINAO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:813-352-3569
Mailing Address - Street 1:4406 NORTH MELTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614
Mailing Address - Country:US
Mailing Address - Phone:813-870-1430
Mailing Address - Fax:
Practice Address - Street 1:4406 NORTH MELTON AVENUE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:813-870-1430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 7338310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility