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General NPI Number Information
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NPI Number | 1972431674
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Entity Type | Organization
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Legal Business Name | HERITAGE HOLISTIC BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 265 KOLLEN PARK DR
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City | HOLLAND
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State | MI
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Zip | 49423-3401
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Country | US
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Telephone | 616-681-3955
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Fax | 616-681-3958
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Provider Business Mailing Address
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Address Line | 265 KOLLEN PARK DR
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City | HOLLAND
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State | MI
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Zip | 49423-3401
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Country | US
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Telephone | 616-681-3955
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Fax | 616-681-3958
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOHNICE FAITH LITTLEJOHN
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Credential | DO MPH
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Telephone | 313-310-9246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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