Healthcare Provider Details

I. General information

NPI: 1679182026
Provider Name (Legal Business Name): HERITAGE ACQUISITION, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S 4TH ST
HENRYETTA OK
74437-5273
US

IV. Provider business mailing address

6760 OLD JACKSONVILLE HWY STE 101
TYLER TX
75703-0566
US

V. Phone/Fax

Practice location:
  • Phone: 918-652-3919
  • Fax: 918-652-2619
Mailing address:
  • Phone: 855-485-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KATRINA DAWN LANIER
Title or Position: SECRETARY
Credential:
Phone: 855-485-8273