# HERITAGE ADULT HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Adult Home LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366139578
- **Authorized official:** ENOCH MUIRURI MBURU (ADMINSTRATOR)
- **Authorized official phone:** (206) 651-1460

## Contact information

- **Practice address:** 16030 NE 14TH CIR, VANCOUVER, WA 98684-8789
- **Practice address phone:** (206) 651-1460
- **Practice address fax:** (360) 314-4020
- **Mailing address:** 16030 NE 14TH CIR, VANCOUVER, WA 98684-8789
- **Mailing address phone:** (206) 651-1460
- **Mailing address fax:** (360) 314-4020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/18/2023
- **Last updated:** 04/18/2023