Provider Demographics
NPI:1578699468
Name:HERITAGE SCHOOLS, INC
Entity Type:Organization
Organization Name:HERITAGE SCHOOLS, INC
Other - Org Name:HERITAGE RESIDENTIAL TREATMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZAUGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-226-4601
Mailing Address - Street 1:5600 N. HERITAGE SCHOOL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604
Mailing Address - Country:US
Mailing Address - Phone:801-226-4600
Mailing Address - Fax:801-226-4693
Practice Address - Street 1:5600 N. HERITAGE SCHOOL DRIVE
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604
Practice Address - Country:US
Practice Address - Phone:801-226-4600
Practice Address - Fax:801-226-4693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11836323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHS549PIMedicaid
UT432132003037Medicaid