Heritage Manor Assisted Living Facility, Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HERITAGE MANOR ASSISTED LIVING FACILITY, CORP

Practice address

1908 E 131St Ave
Tampa, FL 33612-4690

Phone

(813) 977-7878

NPI assigned

Feb 12, 2016

Organization subpart

No

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

Authorized official

Name

Khalid Sakr

Title

Owner

Phone

(727) 439-5363

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1376902874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 E 131ST AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124690",
            "telephone_number": "813-977-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 E 131ST AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124690",
            "telephone_number": "813-977-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MANOR ASSISTED LIVING FACILITY, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "SAKR",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-439-5363"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Herbert
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• Kayla Heredia
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• Darragh Ann Herlihy, NP
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• Assisted Living Facility in Tampa, FL
• Providers in Tampa, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.