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General NPI Number Information
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NPI Number | 1710331913
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Entity Type | Organization
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Legal Business Name | HERITAGE DEVELOPMENTAL CARE INC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 9601 JONES RD STE 150
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City | HOUSTON
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State | TX
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Zip | 77065-4721
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Country | US
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Telephone | 713-885-7844
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Fax | 281-653-9269
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Provider Business Mailing Address
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Address Line | 11455 FALLBROOK DR STE 301A
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City | HOUSTON
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State | TX
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Zip | 77065-4268
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Country | US
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Telephone | 832-866-5264
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Fax | 832-869-4110
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | EMMANUEL ERIMIDE
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Credential |
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Telephone | 832-866-5264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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