Provider Demographics
NPI:1861899247
Name:HERITAGE HOMESTEAD DAY CENTER LLC
Entity type:Organization
Organization Name:HERITAGE HOMESTEAD DAY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-385-7956
Mailing Address - Street 1:516 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270-2040
Mailing Address - Country:US
Mailing Address - Phone:609-602-8865
Mailing Address - Fax:
Practice Address - Street 1:516 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:NJ
Practice Address - Zip Code:08270-2040
Practice Address - Country:US
Practice Address - Phone:609-602-8865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services