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Organization

HERITAGE FOUNDATION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE GATLIN MS, CRC, NCACII, CCS (EXECUTIVE DIRECTOR)
(229) 228-5545
Entity
Organization

Contact information

Practice address
330 REMINGTON AVE, THOMASVILLE, GA 31792-5523
(229) 228-5545
(229) 226-4755
Mailing address
PO BOX 2966, THOMASVILLE, GA 31799-2966
(229) 228-5545
(229) 226-4755

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
136-608D
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000974322A
GA
05
000974322E
GA
Enumeration date
07/10/2014
Last updated
07/10/2014
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