Organization
HERITAGE HEALTH NORTHEAST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD T NICKELL CPA (PRESIDENT)
(423) 510-9504
Entity
Organization
Contact information
Practice address
735 E 10TH ST, CHATTANOOGA, TN 37403-2917
(423) 510-9504
(423) 510-9548
Mailing address
6727 HERITAGE BUSINESS CT, SUITE 712, CHATTANOOGA, TN 37421-7015
(423) 510-9504
(423) 510-9548
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
P0000001470
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3733189
—
TN
Enumeration date
03/30/2007
Last updated
08/22/2020
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