HERITAGE BEHAVIORAL HEALTH CENTER


Address: 4735 E Cantrell St, Decatur, IL 62521-8720
Phone: 2173626262

HERITAGE BEHAVIORAL HEALTH CENTER (NPI# 1245781129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245781129
Entity Type Organization
Organization Name HERITAGE BEHAVIORAL HEALTH CENTER
Other Organization Name HERITAGE AT THOMAS JEFFERSON MIDDLE SCHOOL
Practice Address 4735 E Cantrell St
Decatur
IL 62521-8720
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health 04070 IL Agencies

Other Provider/Organization Names

Other Name Type Code
Heritage at Thomas Jefferson Middle School Doing Business As Name - Organization

Other Provider IDs and Locations

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
1053862920 Heritage Behavioral Health Center Community/Behavioral Health 300 Meadow Terrace Pl, Decatur, IL 62521-5252 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

Other Data Sources

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

Office Location

Street Address 4735 E CANTRELL ST
City DECATUR
State IL
Zip Code 62521-8720

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053927988 Caleb David Braasch Pharmacist 1818 South Airport Rd, Decatur, IL 62521 2020-09-16
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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
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1982839056 Kelly Clark Dds PC Dentist 3737 Us Rt 36 E, Decatur, IL 62521 2009-05-19
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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
1053862920 Heritage Behavioral Health Center Community/Behavioral Health 300 Meadow Terrace Pl, Decatur, IL 62521-5252 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
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Competitor

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City DECATUR
Zip Code 62521

Improve Information

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Dataset Information

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.

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