# HERITAGE HOSPICE, INC.

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

## Provider details

- **NPI number:** 1669462321
- **Authorized official:** MARK AMBROSE (CFO)
- **Authorized official phone:** (812) 429-1845

## Contact information

- **Practice address:** 1202 W. BUENA VISTA RD, SUITE 107, EVANSVILLE, IN 47710
- **Practice address phone:** (812) 475-9712
- **Practice address fax:** (812) 475-9716
- **Mailing address:** 1202 W. BUENA VISTA RD, SUITE 107, EVANSVILLE, IN 47710
- **Mailing address phone:** (812) 475-9712
- **Mailing address fax:** (812) 475-9716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251G00000X | Community Based Hospice Care Agency | 07-0004208-01 | IN | — |
| 314000000X | Skilled Nursing Facility | 004208-1 | IN | Yes |

## Other

- **Enumeration date:** 10/25/2005
- **Last updated:** 03/06/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200513260 | — | IN |
| 05 | — | 200513260A | — | IN |