Healthcare Provider Details

I. General information

NPI: 1780294728
Provider Name (Legal Business Name): HERITAGE DEVELOPMENTAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 JONES RD STE 150
HOUSTON TX
77065-4721
US

IV. Provider business mailing address

11455 FALLBROOK DR STE 301A
HOUSTON TX
77065-4268
US

V. Phone/Fax

Practice location:
  • Phone: 713-885-7844
  • Fax: 281-653-9269
Mailing address:
  • Phone: 832-866-5264
  • Fax: 832-534-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MR. EMMANUEL TEMIDIRE ERIMIDE
Title or Position: ADMINISTRATOR
Credential:
Phone: 713-885-7844