Organization
HERITAGE BEHAVIORAL CENTER, LLC
Active
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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