Provider Demographics
NPI:1598302895
Name:LDB ENTERPRISES LLC.DBA HERITAGEHOMES
Entity Type:Organization
Organization Name:LDB ENTERPRISES LLC.DBA HERITAGEHOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-390-4174
Mailing Address - Street 1:1354 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-3437
Mailing Address - Country:US
Mailing Address - Phone:256-543-0050
Mailing Address - Fax:256-203-4920
Practice Address - Street 1:1354 FORREST AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-3437
Practice Address - Country:US
Practice Address - Phone:256-543-0050
Practice Address - Fax:256-203-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities