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1437176427

NPI Code Detail

MEDICARE: HERITAGE HILLS LIVING CENTER, LLC

MEDICARE: HERITAGE HILLS LIVING CENTER, 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
1	314000000X	Skilled Nursing Facility	NH0090	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437176427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE HILLS LIVING CENTER, LLC

Provider Business Mailing Address
First Line	:	101 GRACE DR
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29640-9088
Country	:	US
Telephone Number	:	864-269-3725
Fax Number	:	864-295-3383

Provider Business Practice Location Address
First Line	:	2051 COUNTRY CLUB RD
Second Line	:
City	:	WADESBORO
State	:	NC
Zip	:	28170-3203
Country	:	US
Telephone Number	:	704-694-4106
Fax Number	:	704-694-6271

Authorized Official
Title or Position	:	VP & CFO
Name	:	MR. JOHN F. SWIFT
Credential	:
Telephone Number	:	864-269-3725

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	03/10/2008

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Directions to “HERITAGE HILLS LIVING CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

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