Heron House Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10811 Issued in FL

Legal business name

HERON HOUSE ALF LLC

Doing business as

Heron House of Largo

Practice address

2050 E Bay Dr
Largo, FL 33771-2321

Phone

(727) 559-7776

NPI assigned

Aug 29, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zevi Kohn

Title

Member

Phone

(718) 338-2999

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heron House of Largo Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1063939148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712321",
            "telephone_number": "727-559-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERON HOUSE ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "ZEVI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-338-2999"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "AL10811",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heron House of Largo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sierra C Heptner
• Laryssa Herbert, LMT
• Marshall L Herbert, M.D.
• Elisabeth Danner Herchan
• Ericka Nicole Hering, APRN
• Yenisleidys Herrera
• Allen V. Hesse, BCABA
• Jennifer P Hickman, APRN
• Lisa Bock Hicks, RPH
• Hidden Oaks Assisted Living Center

• Assisted Living Facility in Largo, FL
• Providers in Largo, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.