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General NPI Number Information
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NPI Number | 1265776389
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Entity Type | Organization
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Legal Business Name | HERITAGE OAKS ALF INC.
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 2801 N. BRANCH FORBES ROAD
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City | TAMPA
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State | FL
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Zip | 33565
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Country | US
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Telephone | 813-752-1076
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Fax | 813-237-2756
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Provider Business Mailing Address
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Address Line | 10759 CORY LAKE DRIVE
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City | TAMPA
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State | FL
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Zip | 33647
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Country | US
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Telephone | 813-352-3569
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Fax | 813-237-2756
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. LOUIE G MACALINAO
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Credential | MBA
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Telephone | 813-352-3569
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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 | 4906
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License Number State | FL
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