Provider Demographics
NPI:1831546886
Name:HERITAGE PALLIATIVE SERVICES, INC.
Entity type:Organization
Organization Name:HERITAGE PALLIATIVE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JANELLE
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-236-2425
Mailing Address - Street 1:120 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1870
Mailing Address - Country:US
Mailing Address - Phone:859-236-2425
Mailing Address - Fax:
Practice Address - Street 1:120 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1870
Practice Address - Country:US
Practice Address - Phone:859-236-2425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty