Provider Demographics
NPI:1710331913
Name:HERITAGE DEVELOPMENTAL CARE INC
Entity Type:Organization
Organization Name:HERITAGE DEVELOPMENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ERIMIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-866-5264
Mailing Address - Street 1:11455 FALLBROOK DR STE 301A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4268
Mailing Address - Country:US
Mailing Address - Phone:832-866-5264
Mailing Address - Fax:832-869-4110
Practice Address - Street 1:11455 FALLBROOK DR STE 301A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4268
Practice Address - Country:US
Practice Address - Phone:832-866-5264
Practice Address - Fax:832-869-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care