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HERITAGE HEALTH NORTHEAST INC NPI 1154441210


NPI Information

NPI: 1154441210
Provider Name: HERITAGE HEALTH NORTHEAST INC
Classification: Day Training/Habilitation Specialist - 373H00000X
Entity Type: Organization
Address:
735 E 10TH ST
CHATTANOOGA, TN
ZIP 37403
Phone: (423) 510-9504
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HERITAGE HEALTH NORTHEAST INC is a day training habilitation specialist in Chattanooga, TN. The provider is individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. HERITAGE HEALTH NORTHEAST INC NPI is 1154441210. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

735 E 10TH ST
CHATTANOOGA, TN
ZIP 37403-917
Phone: (423) 510-9504
Fax: (423) 510-9548

The provider's authorized official is Gerald T Nickell .
The authorized official title is President and has the following contact phone number (423) 510-9504.

The enumeration date for this NPI number is 3/30/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1373H00000XDay Training/Habilitation SpecialistP0000001470TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13733189MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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