The Heritage House on 15TH LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE HERITAGE HOUSE ON 15TH LLC

Practice address

4141 N 15TH St
Milwaukee, WI 53209-6908

Phone

(414) 888-2712

NPI assigned

Mar 14, 2026

Organization subpart

No

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

Authorized official

Name

Jarvis Moore

Title

Owner

Phone

(414) 888-2712

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1773446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773446400000",
    "number": "1902753262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 N 15TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532096908",
            "telephone_number": "414-888-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 N 15TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532096908",
            "telephone_number": "414-888-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HERITAGE HOUSE ON 15TH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JARVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-888-2712"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2026; 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.