Provider Demographics
NPI:1972737450
Name:HERITAGE KEEPERS, LLC
Entity Type:Organization
Organization Name:HERITAGE KEEPERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:L
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-454-6476
Mailing Address - Street 1:6505 W PARK BLVD
Mailing Address - Street 2:#306284
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6208
Mailing Address - Country:US
Mailing Address - Phone:214-454-6476
Mailing Address - Fax:
Practice Address - Street 1:17766 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5736
Practice Address - Country:US
Practice Address - Phone:972-782-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care