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NPI Code Detail

MEDICARE: HERITAGE PLACE

MEDICARE: HERITAGE PLACE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityHAL-026-061NC

General Provider Information

NPI Number : 1194148072
Entity Type Code : Organization
Provider Name (Legal Business Name) : HERITAGE PLACE
Provider Business Mailing Address
First Line : 325 N COOL SPRING ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5137
Country : US
Telephone Number : 910-323-4925
Fax Number : 910-678-8673
Provider Business Practice Location Address
First Line : 325 N COOL SPRING ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5137
Country : US
Telephone Number : 910-323-4925
Fax Number : 910-678-8673
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. JOHN HEATH
Credential :
Telephone Number : 910-323-4925
Provider Enumeration Date : 01/28/2014
Last Update Date : 01/28/2014

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Directions to “HERITAGE PLACE ” Practice Location

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