Provider Demographics
NPI:1245101914
Name:HERITAGE CARE, INC
Entity type:Organization
Organization Name:HERITAGE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAICEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-237-6677
Mailing Address - Street 1:1121 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4119
Mailing Address - Country:US
Mailing Address - Phone:301-237-6677
Mailing Address - Fax:
Practice Address - Street 1:1121 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4119
Practice Address - Country:US
Practice Address - Phone:301-237-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERITAGE CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty