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NPI Code Detail

MEDICARE: HERITAGE CARE GROUP LLC

MEDICARE: HERITAGE CARE GROUP LLC
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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1316897010
Entity Type Code : Organization
Provider Name (Legal Business Name) : HERITAGE CARE GROUP LLC
Provider Business Mailing Address
First Line : 5900 BALCONES DR # 29321
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4257
Country : US
Telephone Number : 361-303-3313
Fax Number :
Provider Business Practice Location Address
First Line : 5900 BALCONES DR # 29321
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4257
Country : US
Telephone Number : 361-303-3313
Fax Number :
Authorized Official
Title or Position : PROGRAM MANAGER/DIRECTOR
Name : MRS. CHRISTY DEANNE CLARK
Credential :
Telephone Number : 361-303-3313
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “HERITAGE CARE GROUP LLC ” Practice Location

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