Provider Demographics
NPI:1679182026
Name:HERITAGE ACQUISITION, LLC.
Entity type:Organization
Organization Name:HERITAGE ACQUISITION, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-485-8273
Mailing Address - Street 1:6760 OLD JACKSONVILLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0566
Mailing Address - Country:US
Mailing Address - Phone:855-485-8273
Mailing Address - Fax:
Practice Address - Street 1:114 S 4TH ST
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437-5273
Practice Address - Country:US
Practice Address - Phone:918-652-3919
Practice Address - Fax:918-652-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based