Healthcare Provider Details

I. General information

NPI: 1154249373
Provider Name (Legal Business Name): HERITAGE ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5060 PLEASANT AVE
FAIRFIELD OH
45014
US

IV. Provider business mailing address

5060 PLEASANT AVE UNIT C
FAIRFIELD OH
45014
US

V. Phone/Fax

Practice location:
  • Phone: 773-681-2013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BINOD KHATIWODA
Title or Position: CO-OWNER
Credential:
Phone: 773-681-2013