NPIMap

Organization Active NPI

Heritage Board & Care #4

  • Mental Illness Community Based Residential Treatment Facility
  • Long Beach, CA
National Provider Identifier
1285084509
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
198600455 Issued in CA
Legal business name
HERITAGE BOARD & CARE #4
Practice address
1509 E 4TH St
Long Beach, CA 90802-1806
Phone
(562) 714-2154
NPI assigned
Jun 17, 2016
Last updated
Jun 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Authorized official

Name
Grace Trinidad
Title
Contact Person
Phone
(562) 714-2154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 198600455 CA Primary

Addresses

Primary practice location

1509 E 4TH St
Long Beach, CA 90802-1806

Mailing address

2330 E 15TH St
Long Beach, CA 90804-1410
Phone (562) 714-2154

National Provider Directory

National Provider Directory
Tax ID family
Heritage Board Care Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1285084509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 E 15TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908041410",
            "telephone_number": "562-714-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 E 4TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021806",
            "telephone_number": "562-714-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE BOARD & CARE #4",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "TRINIDAD",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "CONTACT PERSON",
        "authorized_official_telephone_number": "562-714-2154"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "198600455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.