Provider Demographics
NPI:1902404791
Name:HERITAGE RETREAT MANAGEMENT GROUP, INC.
Entity Type:Organization
Organization Name:HERITAGE RETREAT MANAGEMENT GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-678-2520
Mailing Address - Street 1:4321 KINGWOOD DR # 17
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3700
Mailing Address - Country:US
Mailing Address - Phone:281-678-2520
Mailing Address - Fax:281-354-1237
Practice Address - Street 1:7105 HOT CREEK TRCE
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3098
Practice Address - Country:US
Practice Address - Phone:281-369-4724
Practice Address - Fax:281-354-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility