Active NPI
Heritage Estates, Inc.
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Manteca, CA
National Provider Identifier
1356535389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- License
- 030000451
- 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 INC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2831025 | Other | CA | MEDI-CAL PIN |
Other names 1
- NAVAJO HOME
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 Inc
- 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.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Stockton, CA
- NPI 1083808018
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Manteca, CA
- NPI 1356536965
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Manteca, CA
- NPI 1629263231
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Manteca, CA
- NPI 1710171749
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.