| Organization Name: | HERITAGE ADULT CARE, LLC |
| NPI Number: | 1487097051 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEONARD WEINSTEIN (MANAGER) |
| Mailing Address: | 8601 Rockaway Beach Blvd Rockaway Beach |
| State: | NY US |
| Postal Code: | 116931613 |
| Phone Number: | 7188727677 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2013 |
| NPI Last Update Date: | 04/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |