HERITAGE BEHAVIORAL HEALTH CENTER (NPI# 1508196494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508196494 |
| Entity Type | Organization |
| Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER |
| Practice Address |
151 N Main St Decatur IL 62523-1206 |
| Practice Telephone | 2173626262 |
| Mailing Telephone | 2173626262 |
| Mailing Fax Number | 2173626290 |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2009-12-28 |
| Authorized Official Name | MS. DIANA KNAEBE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2173626262 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
A-0200-002-A | IL | Ambulatory Health Care Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | A-0200-001-A | IL | Residential Treatment Facilities |
| Y | 251S00000X | Community/Behavioral Health | A-0200-002-A | IL | Agencies |
| 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 |
| 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 |
| 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 |
151 N MAIN ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62523-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063029361 | Heritage Behavioral Health Cent Opt | Clinic/Center | 151 N Main St, Decatur, IL 62523-1206 | 2020-09-30 |
| 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 |
| 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 | 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 |
| 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 |
| 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.