MEDICARE: HERITAGE HUMAN SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1699382770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE HUMAN SERVICES

Provider Business Mailing Address
First Line	:	1504 RALPH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3129
Country	:	US
Telephone Number	:	718-629-3187
Fax Number	:	718-629-3498

Provider Business Practice Location Address
First Line	:	1504 RALPH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3129
Country	:	US
Telephone Number	:	718-629-3287
Fax Number	:	718-629-3498

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. FRANCIS NGADI
Credential	:
Telephone Number	:	718-629-3187

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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Directions to “HERITAGE HUMAN SERVICES ” Practice Location

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