Organization
HERITAGE PARK NURSING CENTER LLC
Active
Other names
Heritage Park Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MATHEW VARGHESE (MEMBER)
(917) 817-3530
Entity
Organization
Contact information
Practice address
2302 59TH ST W, BRADENTON, FL 34209-7018
(941) 792-8480
(941) 794-8905
Mailing address
2302 59TH ST W, BRADENTON, FL 34209-7018
(941) 792-8480
(941) 794-8905
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1226095
LICENSE
FL
Enumeration date
07/20/2022
Last updated
07/20/2022
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