Heritage Corner Nursing Home, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HERITAGE CORNER NURSING HOME, LLC

Practice address

1069 Klotz Rd
Bowling Green, OH 43402-4820

Phone

(419) 728-7010

Fax

(419) 728-7030

NPI assigned

May 14, 2012

Organization subpart

No

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

Authorized official

Name

Leslie Dimick

Title

Business Office Manager

Phone

(419) 728-7015

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1518226331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 KLOTZ RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024820",
            "telephone_number": "419-728-7010",
            "fax_number": "419-728-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 KLOTZ RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024820",
            "telephone_number": "419-728-7010",
            "fax_number": "419-728-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE CORNER NURSING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "DIMICK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "419-728-7015"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Henn
• Crystal Henrick
• Mary Henry
• Marissa Rose Hergert
• Heritage Corner Health Care Campus
• Heritage Corner Nursing Home, LLC
• Heritage Corner Therapy, LLC
• Camila Maria Hernandez
• Patricia Hernandez
• Leah Mae Hertenstein, LMT

• Skilled Nursing Facility in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.