Organization Active NPI

Heritage Estates, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Manteca, CA
National Provider Identifier
1356535389
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
030000451 Issued in CA
Legal business name
HERITAGE ESTATES, INC.
Practice address
14646 Navajo Way
Manteca, CA 95336-2525
Phone
(209) 823-6061
Fax
(209) 239-6306
NPI assigned
Sep 3, 2007
Organization subpart
Yes
Parent organization
HERITAGE ESTATES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Ms. Mary A Perry
Title
Secretary/Treasurer
Phone
(209) 823-6061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 030000451 CA Primary

Addresses

Primary practice location

14646 Navajo Way
Manteca, CA 95336-2525

Mailing address

PO Box 293
Manteca, CA 95336-1124
Phone (209) 823-6061

Other identifiers 1

IdentifierTypeStateIssuer
2831025OtherCAMEDI-CAL PIN

Other names 1

  • NAVAJO HOME Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G593

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NAVAJO HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jul 6, 1992
Last certification
Oct 16, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
14646 Navajo Way
Manteca, CA 95336

National Provider Directory

National Provider Directory
Tax ID family
Heritage Estates Inc5 organizations share this tax ID, including this one
Part of
Heritage Estates Inc

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": "1188777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1356535389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953361124",
            "telephone_number": "209-823-6061",
            "fax_number": "209-239-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14646 NAVAJO WAY",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953362525",
            "telephone_number": "209-823-6061",
            "fax_number": "209-239-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE ESTATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERITAGE ESTATES INC",
        "enumeration_date": "2007-09-03",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "209-823-6061",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "030000451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PIN",
            "identifier": "2831025",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NAVAJO HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.