Organization
HERITAGE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL BERGSTEN (MANAGING MEMBER)
(937) 825-6622
Entity
Organization
Contact information
Practice address
24 N HAMILTON ST, MINSTER, OH 45865-1117
(937) 825-6622
Mailing address
544 ENTERPRISE DR, LEWIS CENTER, OH 43035-9704
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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