Provider Demographics
NPI:1780294728
Name:HERITAGE DEVELOPMENTAL CARE INC
Entity type:Organization
Organization Name:HERITAGE DEVELOPMENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:TEMIDIRE
Authorized Official - Last Name:ERIMIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-885-7844
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:832-534-1122
Practice Address - Street 1:9601 JONES RD STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4721
Practice Address - Country:US
Practice Address - Phone:713-885-7844
Practice Address - Fax:281-653-9269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253J00000XAgenciesFoster Care Agency
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient