Provider Demographics
NPI:1538323761
Name:LTP HERITAGE LLC
Entity Type:Organization
Organization Name:LTP HERITAGE LLC
Other - Org Name:OAKHILL SPRINGS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:PANIS
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:925-817-0714
Mailing Address - Street 1:3145 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1839
Mailing Address - Country:US
Mailing Address - Phone:510-533-9970
Mailing Address - Fax:510-533-5488
Practice Address - Street 1:3145 HIGH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1839
Practice Address - Country:US
Practice Address - Phone:510-533-9970
Practice Address - Fax:510-533-5488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555499Medicare Oscar/Certification