| Heritage Foundation Inc | |
|
330 Remington Ave Thomasville GA 31792-5523 | |
| (229) 228-5545 | |
| (229) 226-4755 |
| Full Name | Heritage Foundation Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 330 Remington Ave, Thomasville, Georgia |
| Authorized Official Name and Position | Nicole Gatlin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2292285545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Foundation Inc Po Box 2966 Thomasville GA 31799-2966 Ph: (229) 228-5545 | Heritage Foundation Inc 330 Remington Ave Thomasville GA 31792-5523 Ph: (229) 228-5545 |
| NPI Number | 1609282698 |
|---|---|
| Provider Enumeration Date | 07/10/2014 |
| Last Update Date | 07/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609282698 | NPI | - | NPPES |
| 000974322E | Medicaid | GA | |
| 000974322A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 136-608D (Georgia) | Primary |
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