HERITAGE ESTATES, INC. (NPI# 1710171749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710171749 |
| Entity Type | Organization |
| Organization Name | HERITAGE ESTATES, INC. |
| Other Organization Name | LOCUST HOME |
| Practice Address |
1151 Locust Ave Manteca CA 95337-6863 |
| 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 | 030000239 | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PIN | 3545713 | 01 |
| Other Name | Type Code |
|---|---|
| LOCUST 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 |
| 1083808018 | Heritage Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3565 Sunny Rd, Stockton, CA 95215-8302 | 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 |
1151 LOCUST AVE |
| City | MANTECA |
| State | CA |
| Zip Code | 95337-6863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640485 | Shanitta D Hines | Counselor | Victor Community Support Services, 302 Cherry Lane, CA 95337 | 2020-08-19 |
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1225430655 | Elizabeth Julia Ann Tyner | Hearing Instrument Specialist | 1079 Eucalyptus, Suite B, Manteca, CA 95337 | 2014-09-17 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 1053668947 | Roger Cabo Inciong | Physical Therapist | 3652 Rapallo Way, Manteca, CA 95337 | 2012-08-09 |
| 1295997757 | Costco Wholesale Corporation | Pharmacy | 2440 Daniels St, Manteca, CA 95337 | 2008-06-26 |
| 1255474235 | Carmen Catherine Nunes | Marriage & Family Therapist | 1771 Yosemite Ave., Manteca, CA 95337 | 2007-02-15 |
| 1063577062 | Kathy Laverne Barron | Counselor | 1789 W. Yosemite Ave., Sierra Building, 1st Floor, Manteca, CA 95337 | 2006-12-27 |
| 1891853149 | R. Ciccarelli, Dds., R. Joseph, Dds., M. El Farra, Dds., D. Saini, Dds | Dentist | 1507 W. Yosemite, Manteca, CA 95337 | 2006-12-05 |
| 1467528265 | Annie Mathew | Pharmacist | 1777 West Yosemite Ave, Manteca, CA 95337 | 2006-11-27 |
| Find all providers in zip 95337 | ||||
| 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] |
| 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 |
| 1356535389 | Heritage Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14646 Navajo Way, Manteca, CA 95336-2525 | 2007-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589959 | Mcnamar Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2743 Lowell Dr, Chico, CA 95973-7216 | 2020-08-18 |
| 1386277747 | Trilogy Healthcare, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1989 Edgeview Dr, San Jose, CA 95122-4020 | 2020-02-13 |
| 1093257545 | Casa Edithafoundation Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1756 N Hill Ave, Pasadena, CA 91104-1429 | 2016-11-15 |
| 1336696046 | Mj Asset Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 W Merced Ave, West Covina, CA 91790-3904 | 2016-09-10 |
| 1639571599 | New Providence Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5167 G St, Chino, CA 91710-5143 | 2014-09-23 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.