HERITAGE ESTATES, INC. (NPI# 1083808018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083808018 |
| Entity Type | Organization |
| Organization Name | HERITAGE ESTATES, INC. |
| Other Organization Name | SUNNY ROAD HOME |
| Practice Address |
3565 Sunny Rd Stockton CA 95215-8302 |
| Mailing Address |
Po Box 293 Manteca CA 95336-1124 |
| Practice Telephone | 2098236061 |
| Practice Fax Number | 2092396306 |
| Mailing Telephone | 2098236061 |
| Mailing Fax Number | 2092396306 |
| Enumeration Date | 2007-09-03 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | MS. MARY A PERRY (SECRETARY/TREASURER) |
| Authorized Official Telephone | 2098236061 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE ESTATES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 030000319 | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PIN | 4696713 | 01 |
| Other Name | Type Code |
|---|---|
| SUNNY ROAD HOME | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629263231 | Heritage Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 790 Tahoe St, Manteca, CA 95337-6817 | 2007-09-07 |
| 1356536965 | Heritage Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 304 Wawona St, Manteca, CA 95337-6819 | 2007-09-07 |
| 1710171749 | Heritage Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1151 Locust Ave, Manteca, CA 95337-6863 | 2007-09-03 |
| 1356535389 | Heritage Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14646 Navajo Way, Manteca, CA 95336-2525 | 2007-09-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporation | Heritage Estates, Inc. | 133 Jami-wind Court , Mooresville, NC 28115 |
| Massachusetts Corporation | HERITAGE ESTATES, INC. | 277 MAIN ST. , NASHUA, NH 03060 |
| Street Address |
3565 SUNNY RD |
| City | STOCKTON |
| State | CA |
| Zip Code | 95215-8302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023566098 | U.S. Healthworks Medical Group, PC | Preventive Medicine | 3663 E Arch Rd, Suite 400, Stockton, CA 95215 | 2016-09-19 |
| 1518392067 | Thuy Nhut Nguyen | Pharmacist | 7707 S Austin Rd, Stockton, CA 95215 | 2013-09-03 |
| 1154760270 | Stephanie Skewes | Psychologist | 7707 S Austin Road, Department of State Hospitals-stockton, Stockton, CA 95215 | 2013-06-21 |
| 1053750398 | Steven Cartwright | Psychologist | 7707 S. Austin Road, Department of State Hospitals-stockton, Stockton, CA 95215 | 2013-06-20 |
| 1447520465 | James E Telander | Psychologist | 7650 S. Newcastle Rd., Stockton, CA 95215 | 2012-01-06 |
| 1568479806 | John Carl Molthen | Chiropractor | 4795 E State Route 88, Stockton, CA 95215 | 2006-08-01 |
| 1932735420 | Corrections and Rehabilitation | Pharmacy | 7707 South Austin Road, Room 123, Stockton, CA 95215 | 2020-03-17 |
| 1154471779 | Natalie Collette Farnsworth | Psychologist | 7707 Austin Rd, Stockton, CA 95215 | 2007-01-12 |
| 1972101681 | Mersadez Oller | Behavior Technician | 4815 Joseph Leon Ln, Stockton, CA 95215-1153 | 2020-10-14 |
| 1477809929 | Milagros Moreno Mcarthur | Licensed Psychiatric Technician | 10834 Copperopolis Rd, Stockton, CA 95215-1741 | 2012-08-01 |
| Find all providers in zip 95215 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
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| 1841670551 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 137 Sandy Ridge Rd, Stockton, NJ 08559-1513 | 2015-06-08 |
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| 1427459700 | Good Samaritan Special Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 42612 35th St W, Lancaster, CA 93536-4105 | 2014-09-05 |
| 1699107581 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Dr, Sun Valley, CA 91352-3648 | 2013-08-02 |
| 1790126423 | Contemporary Behavior Consultants, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8032 E Bynum St, Long Beach, CA 90808-3231 | 2013-07-10 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1073868279 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Drive, Sun Valley, CA 91352-3648 | 2012-07-13 |
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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.