# HERITAGE HAVEN HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477406536
- **Authorized official:** MR. BOLAJI S INUOLAJI (ADMINISTRATOR)
- **Authorized official phone:** (269) 532-4520

## Contact information

- **Practice address:** 6031 AVON ST, PORTAGE, MI 49024-2627
- **Practice address phone:** (269) 532-4520
- **Practice address fax:** (206) 657-5255
- **Mailing address:** 6031 AVON ST, PORTAGE, MI 49024-2627
- **Mailing address phone:** (269) 532-4520
- **Mailing address fax:** (206) 665-5255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/18/2026
- **Last updated:** 02/18/2026