Provider Demographics
NPI:1922412246
Name:HERITAGE THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:HERITAGE THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGGREH
Authorized Official - Suffix:
Authorized Official - Credentials:MHR
Authorized Official - Phone:405-801-2240
Mailing Address - Street 1:121 COLLIER DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5273
Mailing Address - Country:US
Mailing Address - Phone:405-928-5996
Mailing Address - Fax:
Practice Address - Street 1:121 COLLIER DR
Practice Address - Street 2:SUITE 600
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5273
Practice Address - Country:US
Practice Address - Phone:405-928-5996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health