Heritage Rehab, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH1252 Issued in WA

Legal business name

HERITAGE REHAB, INC.

Practice address

7411 Pacific Ave
Tacoma, WA 98408-7118

Phone

(253) 474-8456

Fax

(253) 471-2076

NPI assigned

Jan 6, 2006

Organization subpart

No

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

Authorized official

Name

Karl Miller Jr.

Title

Ceo

Phone

(503) 570-3405

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679551808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087118",
            "telephone_number": "253-474-8456",
            "fax_number": "253-471-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-570-3405",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH1252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4112520",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Heppell, MA
• Laura Heppell, BCBA
• Jade Tlana Herbert
• Steven Mark Herbert
• Rebecca Rae Muir Hereford, LCSW
• Heritage Rehab, LLC
• Nancy L Herman, RN, CDE
• Robert A Herman
• Keili Hernandez Guzman
• Gabriela Hernandez Luevano

• Skilled Nursing Facility in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.