Provider Demographics
NPI:1912905167
Name:HERITAGESPRING HEALTH CARE CENTER
Entity Type:Organization
Organization Name:HERITAGESPRING HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:513-707-1537
Mailing Address - Street 1:390 WARDS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6969
Mailing Address - Country:US
Mailing Address - Phone:513-943-4000
Mailing Address - Fax:513-943-4240
Practice Address - Street 1:7235 HERITAGESPRING DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6526
Practice Address - Country:US
Practice Address - Phone:513-759-5777
Practice Address - Fax:513-759-6720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2407314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2509708Medicaid
OH2509708Medicaid