Our Heritage Family Limited

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OUR HERITAGE FAMILY LIMITED

Doing business as

Birch Creek

Practice address

525 N 10TH St
De Pere, WI 54115-1403

Phone

(920) 964-3737

Fax

(920) 964-0614

NPI assigned

Apr 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Roxanne Moreau, RN

Title

Administrator

Phone

(920) 964-3737

Specialties & licenses 1

Addresses

Other names 1

• Birch Creek Doing business as

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073732251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N 10TH ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541151403",
            "telephone_number": "920-964-3737",
            "fax_number": "920-964-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N 10TH ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541151403",
            "telephone_number": "920-964-3737",
            "fax_number": "920-964-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR HERITAGE FAMILY LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOREAU",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-964-3737",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Birch Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.