Organization
HERITAGE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW B DURAKO (EXECUTIVE DIRECTOR)
(570) 826-1031
Entity
Organization
Contact information
Practice address
80 E NORTHAMPTON ST, WILKES BARRE, PA 18701-3035
(570) 826-1031
(570) 826-5053
Mailing address
80 E NORTHAMPTON ST, WILKES BARRE, PA 18701-3035
(570) 826-1031
(570) 826-5053
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
600602
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007475510001
—
PA
Enumeration date
06/30/2005
Last updated
07/13/2007
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