Basic Information
| Provider Information | |||||||||
| NPI: | 1750690244 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HERITAGE HOSPICE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 LEECHBURG RD | ||||||||
| Address2: | BLDG 300 | ||||||||
| City: | NEW KENSINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150684673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243346600 | ||||||||
| FaxNumber: | 7243346601 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 LEECHBURG RD | ||||||||
| Address2: | BLDG 300 | ||||||||
| City: | NEW KENSINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150684673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243346600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | HUNTER | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 4349779711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 17671601 | PA | N | Agencies | Hospice Care, Community Based | 251G00000X | 3979403 | PA | Y | Agencies | Hospice Care, Community Based |
No ID Information.