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General NPI Number Information
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NPI Number | 1790156750
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Entity Type | Organization
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Legal Business Name | HEALTHPRO HERITAGE AT HOME LLC
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 24 TABOR XING
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City | LONGMEADOW
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State | MA
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Zip | 01106-1779
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Country | US
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Telephone | 615-406-3997
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Fax |
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Provider Business Mailing Address
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Address Line | 307 INTERNATIONAL CIR STE 100
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City | HUNT VALLEY
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State | MD
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Zip | 21030-1387
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Country | US
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Telephone | 615-406-3997
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Fax |
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Authorized Official
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Title or Position | DIRECTOR LICENSING AND CERTIFICATIO
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Name | JULIE MCGLASSON
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Credential |
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Telephone | 615-406-3997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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