HERITAGE BEHAVIORAL HEALTH CENTER (NPI# 1053862920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053862920 |
| Entity Type | Organization |
| Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER |
| Other Organization Name | HERITAGE AT GARFIELD MONTESSORI SCHOOL |
| Practice Address |
300 Meadow Terrace Pl Decatur IL 62521-5252 |
| Mailing Address |
151 N Main St Decatur IL 62523-1206 |
| Practice Telephone | 2173626262 |
| Practice Fax Number | 2173626290 |
| Mailing Telephone | 2173626262 |
| Mailing Fax Number | 2173626290 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-18 |
| Authorized Official Name | CANDACE CLEVENGER (PRESIDENT/CEO) |
| Authorized Official Telephone | 2173626262 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 04070 | IL | Agencies |
| Other Name | Type Code |
|---|---|
| Heritage at Garfield Montessori School | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821540865 | Heritage Behavioral Health Center | Counselor | 1029 N Water St, Decatur, IL 62523-1022 | 2016-10-25 |
| 1699226563 | Heritage Behavioral Health Center | Community/Behavioral Health | 300 E Eldorado St, Decatur, IL 62523-1037 | 2016-10-17 |
| 1144771015 | Heritage Behavioral Health Center | Community/Behavioral Health | 1 Educational Park, Decatur, IL 62526-2548 | 2016-10-17 |
| 1245781129 | Heritage Behavioral Health Center | Community/Behavioral Health | 4735 E Cantrell St, Decatur, IL 62521-8720 | 2016-10-17 |
| 1528519584 | Heritage Behavioral Health Center | Community/Behavioral Health | 1499 W Grand Ave, Decatur, IL 62522-1410 | 2016-10-14 |
| 1477727808 | Heritage Behavioral Health Center | Community Based Residential Treatment Facility, Mental Illness | 788 E Clay St, Decatur, IL 62521-2613 | 2008-04-16 |
| 1922277045 | Heritage Behavioral Health Center | Community Based Residential Treatment Facility, Mental Illness | 1421 E Orchard St, Decatur, IL 62521-1459 | 2008-02-22 |
| 1508341371 | Heritage Behavioral Health Center | Case Manager/Care Coordinator | 151 N Main St, Decatur, IL 62523-1206 | 2018-09-27 |
| 1235663949 | Heritage Behavioral Health Center | Counselor | 40 Clinton Plz, Hwy 54, Clinton, IL 61727-2100 | 2017-04-19 |
| 1881128965 | Heritage Behavioral Health Center | Community/Behavioral Health | 40 Clinton Plz, Hwy 54, Clinton, IL 61727-2100 | 2017-04-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HERITAGE BEHAVIORAL HEALTH CENTER, INC. | 151 N Main St, Decatur, IL 62523-1206 |
| Street Address |
300 MEADOW TERRACE PL |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-5252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861028078 | Anchor Home Healthcare Services, Inc. | Community/Behavioral Health | 3717 Elkridge Drive, Decatur, GA 30032 | 2020-03-19 |
| 1881236347 | Alabama Department of Mental Health | Community/Behavioral Health | 401 Lee St Ne Ste 150, Decatur, AL 35601-1902 | 2019-10-16 |
| 1124505177 | Christine Cooper | Community/Behavioral Health | 1925 Old Moulton Rd, Decatur, AL 35601-2752 | 2018-07-23 |
| 1356845937 | D. Bennett Counseling and Consulting Services LLC | Community/Behavioral Health | 614 Valley Brook Rd # 120, Decatur, GA 30033-6022 | 2018-03-20 |
| 1437676632 | Ida's Cove | Community/Behavioral Health | 4280 Memorial Dr Ste C, Decatur, GA 30032-1216 | 2017-08-28 |
| 1699226563 | Heritage Behavioral Health Center | Community/Behavioral Health | 300 E Eldorado St, Decatur, IL 62523-1037 | 2016-10-17 |
| 1144771015 | Heritage Behavioral Health Center | Community/Behavioral Health | 1 Educational Park, Decatur, IL 62526-2548 | 2016-10-17 |
| 1245781129 | Heritage Behavioral Health Center | Community/Behavioral Health | 4735 E Cantrell St, Decatur, IL 62521-8720 | 2016-10-17 |
| 1528519584 | Heritage Behavioral Health Center | Community/Behavioral Health | 1499 W Grand Ave, Decatur, IL 62522-1410 | 2016-10-14 |
| 1851840797 | The Elim Community Development Center | Community/Behavioral Health | 4717 Covington Hwy, Suite 109, Decatur, GA 30035-2015 | 2016-10-03 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.