Provider Demographics
NPI:1003335225
Name:HEATH, FRANKLIN DALE JR (PROGRAM DIRECTOR)
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:DALE
Last Name:HEATH
Suffix:JR
Gender:M
Credentials:PROGRAM DIRECTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3852 PALOS VERDES ST APT 32
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6910
Mailing Address - Country:US
Mailing Address - Phone:702-328-2023
Mailing Address - Fax:
Practice Address - Street 1:3852 PALOS VERDES ST APT 32
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6910
Practice Address - Country:US
Practice Address - Phone:702-328-2023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator