Provider Demographics
NPI:1689608473
Name:HERITAGE HUNT LLC
Entity Type:Organization
Organization Name:HERITAGE HUNT LLC
Other - Org Name:GAINESVILLE HEALTH & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ALESANTRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-725-8910
Mailing Address - Street 1:5372 FALLOWATER LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0907
Mailing Address - Country:US
Mailing Address - Phone:540-725-8910
Mailing Address - Fax:540-725-8914
Practice Address - Street 1:7501 HERITAGE VILLAGE PLZ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3078
Practice Address - Country:US
Practice Address - Phone:571-248-6100
Practice Address - Fax:571-248-6455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2757314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010304067Medicaid
209834OtherANTHEM PROVIDER #
VA249549OtherANTHEM MEDIGAP
VA495388Medicare Oscar/Certification