Organization
HERITAGE HOSPICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK AMBROSE (CFO)
(812) 429-1845
Entity
Organization
Contact information
Practice address
1202 W. BUENA VISTA RD, SUITE 107, EVANSVILLE, IN 47710
(812) 475-9712
(812) 475-9716
Mailing address
1202 W. BUENA VISTA RD, SUITE 107, EVANSVILLE, IN 47710
(812) 475-9712
(812) 475-9716
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
07-0004208-01
IN
314000000X
Skilled Nursing Facility
Primary
004208-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200513260
—
IN
05
—
200513260A
—
IN
Enumeration date
10/25/2005
Last updated
03/06/2017
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