Provider Demographics
NPI:1578317079
Name:HERITAGE HOME, LLC
Entity Type:Organization
Organization Name:HERITAGE HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NURSING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:785-910-1233
Mailing Address - Street 1:234 MANOR CIR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:KS
Mailing Address - Zip Code:66401-8891
Mailing Address - Country:US
Mailing Address - Phone:785-910-1233
Mailing Address - Fax:785-910-1232
Practice Address - Street 1:234 MANOR CIR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:KS
Practice Address - Zip Code:66401-8891
Practice Address - Country:US
Practice Address - Phone:785-910-1233
Practice Address - Fax:785-910-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility