NPIMap

Organization Active NPI

Heritage Residence of Community Care, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • New Hampton, IA
National Provider Identifier
1891832549
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
190405 Issued in IA
Legal business name
HERITAGE RESIDENCE OF COMMUNITY CARE, INC.
Practice address
2275 S Linn Ave
New Hampton, IA 50659-9412
Phone
(641) 394-2391
Fax
(641) 394-2704
NPI assigned
Jan 31, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Benjamin Wright
Title
Executive Director
Phone
(563) 659-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 190405 IA Primary

Addresses

Primary practice location

2275 S Linn Ave
New Hampton, IA 50659-9412

Mailing address

108 Industrial St
De Witt, IA 52742-2063
Phone (563) 659-4100

Other identifiers 1

IdentifierTypeStateIssuer
0896787MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Community Care Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891832549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 INDUSTRIAL ST",
            "city": "DE WITT",
            "state": "IA",
            "postal_code": "527422063",
            "telephone_number": "563-659-4100",
            "fax_number": "563-659-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 S LINN AVE",
            "city": "NEW HAMPTON",
            "state": "IA",
            "postal_code": "506599412",
            "telephone_number": "641-394-2391",
            "fax_number": "641-394-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE RESIDENCE OF COMMUNITY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "563-659-4100"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IA",
            "license": "190405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0896787",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hampton, IA

Sources for this page

  • 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.