Provider Demographics
NPI:1477831162
Name:HERITAGE HOME HEALTH CARE AGENCY OF CLEVELAND HEIGHTS INC
Entity Type:Organization
Organization Name:HERITAGE HOME HEALTH CARE AGENCY OF CLEVELAND HEIGHTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-371-9526
Mailing Address - Street 1:2490 LEE BLVD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1268
Mailing Address - Country:US
Mailing Address - Phone:216-371-9526
Mailing Address - Fax:216-371-9527
Practice Address - Street 1:2490 LEE BLVD
Practice Address - Street 2:SUITE 314
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1268
Practice Address - Country:US
Practice Address - Phone:216-371-9526
Practice Address - Fax:216-371-9527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-28
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health