HERON'S CREEK (NPI# 1669743175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669743175 |
| Entity Type | Organization |
| Organization Name | HERON'S CREEK |
| Practice Address |
112 Red Toad Rd North East MD 21901-2601 |
| Mailing Address |
137 Linton Run Rd Port Deposit MD 21904-1650 |
| Practice Telephone | 4436748745 |
| Mailing Telephone | 4435408949 |
| Mailing Fax Number | 4103784162 |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2012-01-16 |
| Authorized Official Name | MRS. DORIS STACY FAIR (MANAGER) |
| Authorized Official Telephone | 4435408949 |
| Authorized Official Credential | PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL000682 | MD | Nursing & Custodial Care Facilities |
| Street Address |
112 RED TOAD RD |
| City | NORTH EAST |
| State | MD |
| Zip Code | 21901-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653104 | Beth Anders | Social Worker | 2057 Pulaski Highway, North East, MD 21901 | 2019-08-05 |
| 1679029243 | Brenda Fitzgerald | Dental Hygienist | 2057 Pulasky Hwy., Suite 2, North East, MD 21901 | 2016-09-01 |
| 1275818239 | Norman Lane Tosh | Pharmacist | 2556 W Pulaski Hwy, Northj East, MD 21901 | 2011-10-20 |
| 1013194034 | James Moorhouse | Registered Nurse | Perry Point Vamhcs, Perry Point, MD 21901 | 2008-01-22 |
| 1861672016 | Lynda Rae Kopishke | Case Manager/Care Coordinator | 109 North East Isles Drive, Suite 100, North East, MD 21901 | 2007-11-05 |
| 1134220981 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 101 Northeast Road, North East, MD 21901 | 2006-09-26 |
| 1245258516 | Julie T Poludniak | Family Medicine | 322 East Cecil Aveneue, Suite 1, North East, MD 21901 | 2006-07-17 |
| 1730252677 | Carolyn Marie Wells | Social Worker | 1930 Turkey Point Rd, North East, MD 21901 | 2006-11-16 |
| 1881641132 | Keith R Sokoloff | Family Medicine | 14 Rogers Rd, North East, MD 21901 | 2006-05-30 |
| 1538715255 | Ashley Amirah Copes | Behavior Technician | 219 Old Elm Rd, North East, MD 21901-1304 | 2019-08-18 |
| Find all providers in zip 21901 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932264892 | Dear Inc | Assisted Living Facility | 12430 Lake Rd, North East, PA 16428-3545 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486032 | Comfort At Home Care, LLC | Assisted Living Facility | 4628 Marble Hall Rd, Baltimore, MD 21239-3937 | 2020-10-27 |
| 1073113338 | Casa Living Inc | Assisted Living Facility | 13809 Doctor Edelen Dr, Accokeek, MD 20607-3786 | 2020-10-27 |
| 1528667011 | Affluent Living Adult Care | Assisted Living Facility | 4106 Maine Ave, Gwynn Oak, MD 21207-7503 | 2020-10-26 |
| 1134728678 | First-class Caregivers, LLC | Assisted Living Facility | 7214 Willow Hill Dr, Capitol Heights, MD 20743-2671 | 2020-10-24 |
| 1356940761 | Angel Living, LLC | Assisted Living Facility | 3978 Old Washington Rd, Waldorf, MD 20602-3217 | 2020-10-19 |
| 1740896182 | M&o Prestige Partnership LLC | Assisted Living Facility | 1805 Ashburton St, Baltimore, MD 21216-3538 | 2020-09-21 |
| 1497360986 | Merle Newkirk | Assisted Living Facility | 7606 Fox Hunt Ct, Clinton, MD 20735-3063 | 2020-09-10 |
| 1881209690 | Serenity Gardens Assisted Living LLC | Assisted Living Facility | 10829 Burbank Dr, Potomac, MD 20854-1557 | 2020-09-09 |
| 1700491560 | Evergreen Gardens Assisted Living | Assisted Living Facility | 10120 Stansfield Rd, Laurel, MD 20723-1738 | 2020-09-09 |
| 1124632211 | Citadel Management Group Inc. | Assisted Living Facility | 5360 Woodgate Ln, Waldorf, MD 20601-4457 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | NORTH EAST |
| Zip Code | 21901 |
Please comment or provide details below to improve the information on HERON'S CREEK.
| 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.