Organization · NPI-2

Heartland Adult Residential Facility

Assisted Living Facility · Los Angeles, CA

NPI number1154101954
StatusActive
Last updated in NPPESSep 29, 2023

Details

NPI
1154101954
Entity type
Organization (NPI-2)
Legal business name
Heartland Adult Residential Facility
Organization subpart
No
Enumeration date
Sep 29, 2023
Certification date
Sep 29, 2023
Last updated
Sep 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility––Yes
310500000X Intermediate Care Facility, Mental Illness––

Practice location

1847 W 75th St
Los Angeles, CA 90047-2323

Phone 323-434-1404

Mailing address

1847 W 75th St
Los Angeles, CA 90047-2323

Phone 323-434-1404

Authorized official

Nicole Williams
Ceo
3234341404

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