Healthcare Provider Details

I. General information

NPI: 1689608473
Provider Name (Legal Business Name): HERITAGE HUNT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 HERITAGE VILLAGE PLZ
GAINESVILLE VA
20155-3078
US

IV. Provider business mailing address

5372 FALLOWATER LN SUITE 200
ROANOKE VA
24018-0907
US

V. Phone/Fax

Practice location:
  • Phone: 571-248-6100
  • Fax: 571-248-6455
Mailing address:
  • Phone: 540-725-8910
  • Fax: 540-725-8914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2757
License Number StateVA

VIII. Authorized Official

Name: JOSEPH ANTHONY ALESANTRINO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 540-725-8910