HERITAGE BEHAVIORAL HEALTH CENTER (NPI# 1144771015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144771015 |
| Entity Type | Organization |
| Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER |
| Other Organization Name | HERITAGE AT STEPHEN DECATUR MIDDLE SCHOOL |
| Practice Address |
1 Educational Park Decatur IL 62526-2548 |
| 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 Stephen Decatur Middle 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 |
| 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 |
| 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 |
1 EDUCATIONAL PARK |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-2548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851868905 | Michelle Lewis | Audiologist | 1 Educational Park, Decatur, IL 62526 | 2018-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| 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 |
| 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 |
| 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.