MEDICARE: HERITAGE HOMEHEALTH CARE

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	251E00000X	Home Health Agency		NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821106477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE HOMEHEALTH CARE

Provider Business Mailing Address
First Line	:	8212 LOUISIANA BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-2105
Country	:	US
Telephone Number	:	505-796-3200
Fax Number	:	505-796-3234

Provider Business Practice Location Address
First Line	:	2006 BOTULPH RD
Second Line	:	2ND FLOOR
City	:	SANTA FE
State	:	NM
Zip	:	87505-5764
Country	:	US
Telephone Number	:	888-237-8176
Fax Number	:	505-983-8887

Authorized Official
Title or Position	:	CFO
Name	:	MR. STEVE BOURNE
Credential	:
Telephone Number	:	505-796-3236

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	08/22/2020

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Directions to “HERITAGE HOMEHEALTH CARE ” Practice Location

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