| NPI | 1124518204 |
|---|---|
| Doing Business As | MESA HERITAGE CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOHN HOGEBOOM President/CEO 480-831-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management (Licence: AZ OTC8918) |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services (Licence: AZ OTC8918) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: AZ OTC8918) | |
| 291U00000X Clinical Medical Laboratory (Licence: AZ OTC8918) | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2024-08-02 |