| Organization Name: | COUNSELING CENTER AT HERITAGE, LLC |
| NPI Number: | 1548570526 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TINA ROSETTA PAONE (SOLE MEMBER) |
| Mailing Address: | 595 Bethlehem Pike Suite 222 Montgomeryville |
| State: | PA US |
| Postal Code: | 189369710 |
| Phone Number: | 2159977772 |
| Fax Number: | 2154347285 |
| NPI Enumeration Date: | 10/08/2010 |
| NPI Last Update Date: | 02/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |