Provider Demographics
NPI:1538876784
Name:HERITAGE HOME CARE LLC
Entity type:Organization
Organization Name:HERITAGE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:702-816-7735
Mailing Address - Street 1:8611 GABILAN CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-0141
Mailing Address - Country:US
Mailing Address - Phone:702-816-7735
Mailing Address - Fax:
Practice Address - Street 1:8611 GABILAN CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-0141
Practice Address - Country:US
Practice Address - Phone:702-816-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health