HERITAGE ENTERPRISES, INC (NPI# 1104236165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104236165 |
| Entity Type | Organization |
| Organization Name | HERITAGE ENTERPRISES, INC |
| Other Organization Name | GREEN TREE THERAPY |
| Practice Address |
700 E Walnut St Bloomington IL 61701-3244 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 3098291268 |
| Practice Fax Number | 3098293475 |
| Mailing Telephone | 3098237139 |
| Mailing Fax Number | 3098295477 |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |
| Authorized Official Name | DAVID M UNDERWOOD (SR VP & CFO) |
| Authorized Official Telephone | 3098237135 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Green Tree Therapy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Heritage Enterprises, Inc. | 192 South St., Gastonia, NC 28052 |
| Massachusetts Corporations | HERITAGE ENTERPRISES, INC. | P.o. Box 53, Concord, MA 01742 |
| Washington State Corporations | HERITAGE ENTERPRISES, INC. | 9001 Pacific Ave, Tacoma, WA 98444 |
| Colorado Business Entities | HERITAGE ENTERPRISES, INC. | 11131 E. Nugget Drive, Desert Mountain, Painted Sky, Scottsdale, AZ 85262 |
| Indiana Business Entities | HERITAGE ENTERPRISES, INC. | Po Box 100, Stanford, IN 47463 |
| Street Address |
700 E WALNUT ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457343170 | Heritage Manor Bloomington, LLC | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2005-08-18 |
| 1952948705 | Alex Morales | Physical Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2019-11-27 |
| 1770992190 | Katrina Mitchell | Occupational Therapist | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-08-11 |
| 1063821882 | Karma Young | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-08-06 |
| 1336558436 | Kristen Stromberg | Physical Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-08-04 |
| 1124462288 | Whitney Lynn Harper | Physical Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2013-04-19 |
| 1881038941 | Stephanie Steele | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2013-04-19 |
| 1275877979 | Heritage Manor - Bloomington, LLC | Durable Medical Equipment & Medical Supplies | 700 E Walnut St, Bloomington, IL 61701-3244 | 2012-11-19 |
| 1629321443 | Karen Coakley | Occupational Therapist | 700 E Walnut St, Bloomington, IL 61701-3244 | 2012-10-17 |
| 1316268014 | Renda Watterson | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2010-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962987255 | Ptworx LLC | Clinic/Center | 5006 S Rogers St, Bloomington, IN 47403-4655 | 2018-10-02 |
| 1013030352 | Physiotherapy Associates Inc | Clinic/Center | 1355 W Bloomfield Rd Ste B, Bloomington, IN 47403-2052 | 2007-04-10 |
| 1518049337 | Illinois Physical Therapy Associates Limited Partnership | Clinic/Center | 3609 General Electric Rd, Suite B, Bloomington, IL 61704-8534 | 2006-10-20 |
| 1720549892 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 2455 N Tamarack Trl, Bloomington, IN 47408-1294 | 2019-03-29 |
| 1487164869 | Vitalrehab Physical Therapy, LLC | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2017-10-11 |
| 1316473325 | Embody Boss LLC | Clinic/Center | 128 E 6th St, Bloomington, IN 47408-3311 | 2017-05-11 |
| 1639565971 | Champion Fitness, Inc | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2015-04-14 |
| 1700279007 | Delong Wellness, LLC | Clinic/Center | 218 N Rogers St, Bloomington, IN 47404-3969 | 2015-03-11 |
| 1861810228 | Rally Physical Therapy LLC | Clinic/Center | 19165 Meander Way, Bloomington, IL 61705-5227 | 2014-04-02 |
| 1134437460 | Institute for Athletic Medicine | Clinic/Center | 600 W 98th St, Bloomington, MN 55420-4773 | 2010-09-21 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
Please comment or provide details below to improve the information on HERITAGE ENTERPRISES, INC.
| 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.