HERITAGE GROUP HOMES, INC. (NPI# 1306398185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306398185 |
| Entity Type | Organization |
| Organization Name | HERITAGE GROUP HOMES, INC. |
| Other Organization Name | HERITAGE YOUTH SERVICES 3 |
| Practice Address |
1923 E Eckerman Ave West Covina CA 91791-1113 |
| Mailing Address |
Po Box 8400 La Verne CA 91750-8400 |
| Practice Telephone | 6263324600 |
| Practice Fax Number | 9095998223 |
| Mailing Telephone | 9095998222 |
| Mailing Fax Number | 9095998223 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2019-03-05 |
| Authorized Official Name | MRS. SANDI HEYER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6266531000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 197801967 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Group Homes III | Other Name - Individual/Organization |
| Heritage Youth Services 3 | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013469881 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 30 Country Wood Dr, Phillips Ranch, CA 91766-4818 | 2016-10-27 |
| 1467904235 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 16226 E. Benwick St, Valinda, CA 91744-1301 | 2016-10-27 |
| 1346804432 | Heritage Group Homes, Inc. | Point of Service | 158 Gentry St, Pomona, CA 91767-2100 | 2019-04-24 |
| 1285186981 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1940 Baseline Rd, La Verne, CA 91750-2148 | 2016-10-28 |
| 1396297172 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8814 Santa Fe Springs Rd, Whittier, CA 90606-2821 | 2016-10-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HERITAGE GROUP HOMES, INC. | 158 Gentry St, Pomona, CA 91767-2100 |
| Street Address |
1923 E ECKERMAN AVE |
| City | WEST COVINA |
| State | CA |
| Zip Code | 91791-1113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710344577 | Astrid Topete | Marriage & Family Therapist | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2016-01-25 |
| 1851911465 | Maria Serratos | Case Manager/Care Coordinator | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2020-04-23 |
| 1174142178 | Crystal Rose Miller | Rehabilitation Practitioner | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2020-04-10 |
| 1134768526 | Jennifer Gonzalez | Case Manager/Care Coordinator | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2020-01-02 |
| 1760027122 | Mirian Denis Tenorio | Rehabilitation Practitioner | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2019-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938896 | Oriental Holistic Acupuncture Healthe Center Inc | Acupuncturist | 1414 S. Azusa Ave., Ste B-5, West Covina, CA 91791 | 2018-07-09 |
| 1780110312 | Yenmien Chen | Pharmacist | 5944 N Figueroa Ave, Los Angeles, CA 91791 | 2017-05-02 |
| 1568861227 | Gashparova Dental Practice Inc. | Dentist | 628 N. Azusa Ave., West Covina, CA 91791 | 2014-08-19 |
| 1740607837 | Melinda Rodriguez-mendoza | Nurse Practitioner | 1444 E Mcwood St, West Covina, CA 91791 | 2014-03-26 |
| 1710245782 | Mark Chevy S Ledesma | Dentist | 319 N Azusa Ave., W Covina, CA 91791 | 2012-04-27 |
| 1508184920 | Elba Cecilia Olivares | Chiropractor | 743 S. Hillward Ave, West Covina, CA 91791 | 2010-05-10 |
| 1861668832 | Susette C Thompson | Case Manager/Care Coordinator | 1829 Eworkman Ave #1, West Covina, CA 91791 | 2008-04-30 |
| 1376729483 | Accentcare Home Health of California, Inc. | Home Health | 2934 E Garvey Ave S Ste 210, West Covina, CA 91791 | 2008-01-18 |
| 1629195870 | Jung Jung Liu | Dentist | 628 North Azusa Ave, West Covina, CA 91791 | 2007-03-23 |
| 1548302748 | Mark Chevy S Ledesma Dds Inc | Dentist | 319 N Azusa Ave, W Covina, CA 91791 | 2007-02-13 |
| Find all providers in zip 91791 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568913887 | Careprovider Org Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 517 N Chalburn Ave, West Covina, CA 91790-1446 | 2016-10-21 |
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| City | WEST COVINA |
| Zip Code | 91791 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.