Organization Active NPI

Heritage Health Care & Rehab, Inc.

  • Skilled Nursing Facility
  • Tuscaloosa, AL
National Provider Identifier
1184719247
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
12691 Issued in AL
Legal business name
HERITAGE HEALTH CARE & REHAB, INC.
Practice address
1101 Snows Mill Avenue
Tuscaloosa, AL 35406-2015
Phone
(205) 759-5179
Fax
(205) 759-5216
NPI assigned
Oct 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. George L Jackson
Title
Administrator
Phone
(205) 759-5179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 12691 AL Primary

Addresses

Primary practice location

1101 Snows Mill Avenue
Tuscaloosa, AL 35406-2015

Mailing address

1101 Snows Mill Avenue
Tuscaloosa, AL 35406-2015
Phone (205) 759-5179

Other identifiers 1

IdentifierTypeStateIssuer
4754110SMedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000933 AL Part A Provider - Skilled Nursing Facility 4880590736 Practice locations: Tuscaloosa, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184719247. Details of each certification follow.

Skilled nursing facility certification: CCN 015371

Legal name
HERITAGE HEALTH CARE & REHAB, INC.
Doing business as
HERITAGE HEALTH CARE & REHAB, INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1977
Last certification
Jan 27, 2022
Beds
216
Ownership / control type
Corporation
Most recent change of ownership
Jan 1, 2004
Organization structure
CorporationProprietary
Enrollment address
1101 Snows Mill Ave
Tuscaloosa, AL 35406-2015
Nursing home name
HERITAGE HEALTH CARE & REHAB INC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage Health Care & Rehab IncCCN 015371 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
216135.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0301865Heritage Health Care & Rehab Inc1101 Snows Mill Ave, Tuscaloosa, AL 35406Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Individual Adp of the SNF Jun 1, 2021
Individual Adp of the SNF Nov 1, 2014
Organization, Pelham, AL Medical provider/supplier Adp of the SNF Oct 1, 2025
Organization, Warrior, AL Consulting firm Trustee of the SNF Aug 1, 2012
Adp of the SNF Oct 1, 2025
Blake E Jackson Individual Corporate OfficerSecretary Jan 1, 2019
Operational/Managerial Control Jan 1, 2018
Trustee of the SNF Jan 1, 2018
Adp of the SNF Mar 23, 2018
Organization, Omaha, NE Medical staffing company Trustee of the SNF Jul 15, 2023
Adp of the SNF Oct 1, 2025
Benjamin E Jackson Individual 5% Or Greater Direct Ownership Interest Nov 25, 2003 100%
Corporate OfficerPresident Nov 25, 2003 100%
Corporate DirectorPresident Nov 25, 2003 100%
Trustee of the SNF Jan 1, 2003
Adp of the SNF Jun 10, 1975
Organization, Weston, FL Medical staffing company Trustee of the SNF Jul 15, 2023
Adp of the SNF Oct 1, 2025

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184719247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SNOWS MILL AVENUE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062015",
            "telephone_number": "205-759-5179",
            "fax_number": "205-759-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SNOWS MILL AVENUE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062015",
            "telephone_number": "205-759-5179",
            "fax_number": "205-759-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HEALTH CARE & REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-759-5179",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4754110S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.