Heritage Health Management 1, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

031530 Issued in MO

Legal business name

HERITAGE HEALTH MANAGEMENT 1, LLC

Practice address

3000 NE 64TH Street
Gladstone, MO 64119

Phone

(816) 454-5130

Fax

(816) 454-5130

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Schechter

Title

Managing Member

Phone

(224) 233-1305

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Blue Sky Management, LLC Former legal business name

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1831260272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 NE 64TH STREET",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64119",
            "telephone_number": "816-454-5130",
            "fax_number": "816-459-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NE 64TH STREET",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64119",
            "telephone_number": "816-454-5130",
            "fax_number": "816-454-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HEALTH MANAGEMENT 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "SCHECHTER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "224-233-1305",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "031530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266715408",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266715002",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Sky Management, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Assisted Living Facility in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.