HERITAGE BEHAVIORAL HEALTH CENT OPT (NPI# 1063029361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063029361 |
| Entity Type | Organization |
| Organization Name | HERITAGE BEHAVIORAL HEALTH CENT OPT |
| Practice Address |
151 N Main St Decatur IL 62523-1206 |
| Mailing Address |
Po Box 710 Decatur IL 62525-0710 |
| Practice Telephone | 2173626262 |
| Practice Fax Number | 2173626290 |
| Mailing Telephone | 2174204776 |
| Mailing Fax Number | 2173626290 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | AMBER NICOLE GREEN (CLINICAL FINANCIAL SPECIALIST) |
| Authorized Official Telephone | 2174204776 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Street Address |
151 N MAIN ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62523-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881217206 | William Jihan | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-20 |
| 1053934471 | Jasmine M Kaylor | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-20 |
| 1891318218 | Andrea L Mccoy | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-20 |
| 1366065989 | Lindsay M Orlowski | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-19 |
| 1578186185 | Whitley B Hofer | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-19 |
| 1760003586 | Megan R Markwell | Registered Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-04 |
| 1316568132 | Erin Taylor | Registered Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-04 |
| 1902427982 | Latasha L Patton | Licensed Practical Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-01 |
| 1710508692 | Tayler J Dance | Licensed Practical Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-01 |
| 1992326979 | Stephanie P Conlin | Licensed Practical Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548763238 | Community Health Improvement Center | Clinic/Center | 1027 N Water, Decatur, IL 62523 | 2018-03-09 |
| 1093091597 | Leesa K Reed | Social Worker | 151 N. Main St., Heritage Behavioral Health, Decatur, IL 62523 | 2011-10-27 |
| 1407001357 | Pamela Sue Waterman | Counselor | 720 E. Wood St., Decatur, IL 62523 | 2008-11-19 |
| 1639231731 | Heritage Behavioral Health Center Inc. | Clinic/Center | 151 N Main Street, Decatur, IL 62523 | 2006-12-14 |
| 1669561080 | Diane S Pleasant | Counselor | 335 E Wood St Ste B, Decatur, IL 62523 | 2006-10-12 |
| 1376642470 | Gudrun Birgitta Armentrout | Marriage & Family Therapist | 247 West Prairie, Catholics Charities, Decatur, IL 62523 | 2006-09-22 |
| 1871117887 | Restore Wellness Counseling LLC | Social Worker | 106 North Main Street, Decatur, IL 62523 | 2020-06-04 |
| 1275004186 | Stephanie Maurer | Physician Assistant | 320 Central Ave, Decatur, IL 62523 | 2018-12-17 |
| 1669673620 | Decatur Public School Dist. #61 | Local Education Agency (LEA) | 101 W Cerro Gordo St, Decatur, IL 62523-1001 | 2007-05-29 |
| 1295246320 | Barbara A Nadler | Speech-Language Pathologist | 101 W Cerro Gordo St, Decatur, IL 62523-1001 | 2017-10-16 |
| Find all providers in zip 62523 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639231731 | Heritage Behavioral Health Center Inc. | Clinic/Center | 151 N Main Street, Decatur, IL 62523 | 2006-12-14 |
| 1508196494 | Heritage Behavioral Health Center | Clinic/Center | 151 N Main St, Decatur, IL 62523-1206 | 2009-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862457 | Jem Treatment, Inc | Clinic/Center | 2424 Washington St Ste Ll-110, Waukegan, IL 60085-5074 | 2020-02-05 |
| 1124659123 | Lake County Center, LLC | Clinic/Center | 310 S Greenleaf St Ste 206207, Gurnee, IL 60031-5708 | 2020-01-29 |
| 1750883286 | Buena Vista Group, LLC | Clinic/Center | 418 Dixie Hwy, Chicago Heights, IL 60411-1739 | 2018-02-28 |
| 1518485960 | The Bobby Buonauro Clinic | Clinic/Center | 1029 Howard St Ste 303, Evanston, IL 60202-3877 | 2017-09-06 |
| 1689196578 | Serenity Treatment and Counseling Center Inc | Clinic/Center | 19408 North Creek Drive, Lynwood, IL 60411-8649 | 2017-07-12 |
| 1699296129 | Loren 'half' Robinson Foundation | Clinic/Center | 4100 W Ogden Ave, Chicago, IL 60623-2821 | 2017-07-06 |
| 1942744453 | Recovery Concepts LLC | Clinic/Center | 17100 Dixie Hwy, Suite D & E, Hazel Crest, IL 60429-1485 | 2016-12-19 |
| 1184022303 | Renewed Hope Community Services Inc. | Clinic/Center | 626 E 71st St, Chicago, IL 60619-1212 | 2014-12-22 |
| 1316296007 | Sundance Methadone Treatment Center,llc | Clinic/Center | 4545 N Broadway St, 3rd Floor, Chicago, IL 60640-5975 | 2012-09-10 |
| 1790030344 | Ijegba Community Inc | Clinic/Center | 1950 E 75th St, Chicago, IL 60649-3633 | 2012-07-19 |
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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.