Heritage Hills Living Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0090 Issued in NC

Legal business name

HERITAGE HILLS LIVING CENTER, LLC

Practice address

2051 Country Club Rd
Wadesboro, NC 28170-3203

Phone

(704) 694-4106

Fax

(704) 694-6271

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John F. Swift

Title

VP & Cfo

Phone

(864) 269-3725

Specialties & licenses 1

Addresses

Other identifiers 6

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1437176427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GRACE DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296409088",
            "telephone_number": "864-269-3725",
            "fax_number": "864-295-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 COUNTRY CLUB RD",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281703203",
            "telephone_number": "704-694-4106",
            "fax_number": "704-694-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HILLS LIVING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "SWIFT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "864-269-3725",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802904",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415392",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416086",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3426086",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3425392",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RH 7802904",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.