Provider Demographics
NPI:1932125770
Name:HERITAGE HOME HEALTHCARE & HOSPICE, INC
Entity type:Organization
Organization Name:HERITAGE HOME HEALTHCARE & HOSPICE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-390-4040
Mailing Address - Street 1:6700 JEFFERSON ST NE BLDG D2
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4394
Mailing Address - Country:US
Mailing Address - Phone:505-232-3311
Mailing Address - Fax:505-216-2794
Practice Address - Street 1:6700 JEFFERSON ST NE
Practice Address - Street 2:SUITE D2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5567
Practice Address - Country:US
Practice Address - Phone:505-796-3200
Practice Address - Fax:505-796-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3205251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM40884864Medicaid
NM321558Medicare PIN