Healthcare Provider Details

I. General information

NPI: 1144641861
Provider Name (Legal Business Name): HERITAGE SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2013
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 WILSHIRE BLVD STE 2200
LOS ANGELES CA
90010-2632
US

IV. Provider business mailing address

447 N EL MOLINO AVE
PASADENA CA
91101-1403
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-4400
  • Fax: 213-382-4494
Mailing address:
  • Phone: 626-577-8480
  • Fax: 626-577-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: VATCHE KELARTINIAN
Title or Position: CEO
Credential:
Phone: 626-577-8480