Provider Demographics
NPI:1962045526
Name:HERITAGE HOME AND DAY HEALTHCARE
Entity Type:Organization
Organization Name:HERITAGE HOME AND DAY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-244-9859
Mailing Address - Street 1:4511 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4001
Mailing Address - Country:US
Mailing Address - Phone:502-244-9859
Mailing Address - Fax:770-573-9513
Practice Address - Street 1:1517 CRUMS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-3823
Practice Address - Country:US
Practice Address - Phone:502-214-3210
Practice Address - Fax:800-214-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care