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Organization

HERITAGE CARE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUAN CAICEDO (EXECUTIVE DIRECTOR)
(301) 237-6677
Entity
Organization

Contact information

Practice address
5711 SARVIS AVE STE 100, RIVERDALE, MD 20737-1363
(301) 237-6677
(301) 576-3987
Mailing address
5711 SARVIS AVE STE 100, RIVERDALE, MD 20737-1363
(301) 237-6677
(301) 576-3987

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103TB0200X
Cognitive & Behavioral Psychologist
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
448208500
MD
Enumeration date
09/06/2022
Last updated
09/06/2022
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