Organization Active NPI

Heartland Adult Residential Facility

  • Assisted Living Facility
  • Los Angeles, CA
National Provider Identifier
1154101954
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
HEARTLAND ADULT RESIDENTIAL FACILITY
Practice address
1847 W 75TH St
Los Angeles, CA 90047-2323
Phone
(323) 434-1404
NPI assigned
Sep 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Mrs. Nicole Williams
Title
Ceo
Phone
(323) 434-1404

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary
Mental Illness Intermediate Care Facility 310500000X

Addresses

Primary practice location

1847 W 75TH St
Los Angeles, CA 90047-2323

Mailing address

1847 W 75TH St
Los Angeles, CA 90047-2323
Phone (323) 434-1404

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1154101954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 W 75TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472323",
            "telephone_number": "323-434-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 W 75TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472323",
            "telephone_number": "323-434-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND ADULT RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-434-1404",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.