Heritage Behavioral Center, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10796H Issued in AZ

Legal business name

HERITAGE BEHAVIORAL CENTER, LLC

Doing business as

Heritage Living Center

Practice address

17442 N 28TH St
Phoenix, AZ 85032-1903

Phone

(602) 595-8338

Fax

(602) 354-7174

NPI assigned

Aug 13, 2018

Last updated

Feb 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Satwant Bhowra

Title

Accounts Manager

Phone

(602) 550-4065

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Living Center Doing business as

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1740769470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47090",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850687090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17442 N 28TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850321903",
            "telephone_number": "602-595-8338",
            "fax_number": "602-354-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE BEHAVIORAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "BHOWRA",
        "authorized_official_first_name": "SATWANT",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "602-550-4065"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL10796H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "AL10796H",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Agustin Peralta Herber II, DO
• Herbert R. Kahn, M.D., P.a.
• Lauren Bailey Herd
• Here4U Transport LLC
• Desiree Monique Heredia
• Heritage Home Healthcare of Arizona, Inc
• Heritage House Behavioral Health Services
• Heritage Recovery Treatment Center, LLC
• Cienna Herlihy
• Erin Christine Herling, MS, CCC-SLP

• Assisted Living Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.