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General NPI Number Information
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NPI Number | 1063942647
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Entity Type | Organization
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Legal Business Name | HERITAGE LIVING INC
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 10411 BLYTHE CT
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9681
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Country | US
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Telephone | 661-979-0417
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Fax |
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Provider Business Mailing Address
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Address Line | 10411 BLYTHE CT
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City | BAKERSFIELD
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State | CA
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Zip | 93311
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Country | US
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Telephone | 661-979-0417
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Fax |
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Authorized Official
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Title or Position | PRECIDENT
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Name | TINA MALHI
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Credential |
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Telephone | 661-979-0417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 157206726
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License Number State | CA
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