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General NPI Number Information
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NPI Number | 1104152594
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Entity Type | Organization
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Legal Business Name | HERITAGE ADULT DAYCARE INC
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 8240 LOCH RAVEN BLVD
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City | TOWSON
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State | MD
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Zip | 21286-8200
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Country | US
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Telephone | 410-825-5575
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Fax | 410-825-5578
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Provider Business Mailing Address
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Address Line | 304 REISTERSTOWN RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-5312
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Country | US
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Telephone | 410-825-5575
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Fax | 410-825-5578
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. DANIEL TROSMAN
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Credential |
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Telephone | 410-825-5575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | MD
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