| NPI | 1194397240 |
|---|---|
| Doing Business As | HERITAGE HEALTH CFHL CDA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BAKER CEO 208-292-0256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 103TC1900X Psychologist, Counseling | |
| 101YM0800X Counselor, Mental Health | |
| 101Y00000X Counselor | |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| 1041C0700X Social Worker, Clinical | |
| 363A00000X Physician Assistant | |
| 101YS0200X Counselor, School | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2025-11-03 |