| NPI | 1053980110 |
|---|---|
| Doing Business As | HERITAGE HEALTH |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BAKER CEO 208-415-0299 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YS0200X Counselor, School | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 207Q00000X Family Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2022-09-12 |