# HERITAGE GROUP HOMES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Youth Services 1
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013469881
- **Authorized official:** MARIA SERRATOS (PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (909) 599-8222

## Contact information

- **Practice address:** 30 COUNTRY WOOD DR, PHILLIPS RANCH, CA 91766-4818
- **Practice address phone:** (909) 623-3400
- **Practice address fax:** (909) 599-8223
- **Mailing address:** PO BOX 8400, LA VERNE, CA 91750-8400
- **Mailing address phone:** (909) 599-8222
- **Mailing address fax:** (909) 599-8223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 197804150 | CA | Yes |

## Other

- **Enumeration date:** 10/27/2016
- **Last updated:** 06/21/2023