Active NPI
Heritage Haven Home
- Home Health Agency
- Portage, MI
National Provider Identifier
1477406536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- HERITAGE HAVEN HOME
- Practice address
- 6031 Avon St
Portage, MI 49024-2627 - Phone
- (269) 532-4520
- Fax
- (206) 657-5255
- NPI assigned
- Feb 18, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bolaji S Inuolaji
- Title
- Administrator
- Phone
- (269) 532-4520
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
6031 Avon St
Portage, MI 49024-2627
Mailing address
6031 Avon St
Portage, MI 49024-2627
Phone (269) 532-4520
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771372800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771372800000",
"number": "1477406536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6031 AVON ST",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490242627",
"telephone_number": "269-532-4520",
"fax_number": "206-665-5255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6031 AVON ST",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490242627",
"telephone_number": "269-532-4520",
"fax_number": "206-657-5255"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HERITAGE HAVEN HOME",
"organizational_subpart": "NO",
"enumeration_date": "2026-02-18",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A",
"authorized_official_last_name": "INUOLAJI",
"authorized_official_first_name": "BOLAJI",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "269-532-4520",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.