Organization Name: | HERITAGE HEALTHCARE GROUP, LLC |
NPI Number: | 1225392046 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN DACY (DIRECTOR) |
Mailing Address: | 316 N Milwaukee St Suite 208 Milwaukee |
State: | WI US |
Postal Code: | 532025885 |
Phone Number: | 8883899030 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2012 |
NPI Last Update Date: | 02/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |