Provider Demographics
NPI:1023154283
Name:HERITAGE HILLS LLC
Entity type:Organization
Organization Name:HERITAGE HILLS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SORMANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-231-2700
Mailing Address - Street 1:80 DOUGLAS PIKE
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2339
Mailing Address - Country:US
Mailing Address - Phone:401-231-2700
Mailing Address - Fax:401-231-2703
Practice Address - Street 1:80 DOUGLAS PIKE
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2339
Practice Address - Country:US
Practice Address - Phone:401-231-2700
Practice Address - Fax:401-231-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI730314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIHH44226Medicaid
RI415039Medicare ID - Type UnspecifiedPROVIDER NUMBER