Healthcare Provider Details

I. General information

NPI: 1043293087
Provider Name (Legal Business Name): HERITAGE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S MASON RD STE 108
KATY TX
77450-3935
US

IV. Provider business mailing address

6760 OLD JACKSONVILLE HWY SUITE 101
TYLER TX
75703-0572
US

V. Phone/Fax

Practice location:
  • Phone: 979-848-8925
  • Fax: 979-848-8565
Mailing address:
  • Phone: 855-485-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number003340
License Number StateTX

VIII. Authorized Official

Name: KATRINA DAWN LANIER
Title or Position: CHIEF GROWTH OFFICER
Credential: LVN
Phone: 855-485-8273