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Organization

HERITAGE HAVEN HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BOLAJI S INUOLAJI (ADMINISTRATOR)
(269) 532-4520
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
02/18/2026
Last updated
02/18/2026
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