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General NPI Number Information
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NPI Number | 1487097051
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Entity Type | Organization
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Legal Business Name | HERITAGE ADULT CARE, LLC
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 8601 ROCKAWAY BEACH BLVD
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1613
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Country | US
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Telephone | 718-872-7677
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Fax |
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Provider Business Mailing Address
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Address Line | 8601 ROCKAWAY BEACH BLVD
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LEONARD WEINSTEIN
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Credential |
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Telephone | 718-872-7677
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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 |
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