{
"Npi": {
"NPI": "1316029549",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HERITAGE HOME HEALTHCARE SERVICES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6700 JEFFERSON ST NE BLDG D2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBUQUERQUE",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87109-4394",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "575-556-2103",
"MailingAddressFaxNumber": "575-556-2181",
"FirstLinePracticeLocationAddress": "6700 JEFFERSON ST NE BLDG D2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALBUQUERQUE",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87109-4394",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "575-556-2103",
"PracticeLocationAddressFaxNumber": "575-556-2181",
"EnumerationDate": "10/19/2006",
"LastUpdateDate": "10/28/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARBERRY",
"AuthorizedOfficialFirstName": "SUSAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF COMPLIANCE OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "903-390-4040",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "3003",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}