Organization
HERITAGE BEHAVIORAL CENTER, LLC
Active
Other names
Heritage Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
SATWANT BHOWRA (ACCOUNTS MANAGER)
(602) 550-4065
Entity
Organization
Contact information
Practice address
17442 N 28TH ST, PHOENIX, AZ 85032-1903
(602) 595-8338
(602) 354-7174
Mailing address
PO BOX 47090, PHOENIX, AZ 85068-7090
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10796H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL10796H
STATE LICENSE NUMBER
AZ
Enumeration date
08/13/2018
Last updated
02/19/2020
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