Provider Demographics
NPI:1649087883
Name:HERITAGE OF HOPE ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:HERITAGE OF HOPE ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRESETH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-451-9717
Mailing Address - Street 1:15856 COBBLESTONE LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7863
Mailing Address - Country:US
Mailing Address - Phone:952-451-9717
Mailing Address - Fax:
Practice Address - Street 1:5641 BABCOCK TRL
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55077-2108
Practice Address - Country:US
Practice Address - Phone:952-451-9717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERITAGE OF HOPE ASSISTED LIVING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility