HERITAGE BEHAVIORAL HEALTH CENTER, INC (NPI# 1235527524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235527524 |
| Entity Type | Organization |
| Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER, INC |
| Other Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER, INC |
| Practice Address |
327 W Prairie Ave Decatur IL 62522-2444 |
| Mailing Address |
151 N Main St Decatur IL 62523 |
| Practice Telephone | 2174230548 |
| Practice Fax Number | 2176326290 |
| Mailing Telephone | 2173626262 |
| Mailing Fax Number | 2173626290 |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2016-05-10 |
| Authorized Official Name | CANDACE CLEVENGER (PRESIDENT/CEO) |
| Authorized Official Telephone | 2174204703 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE BEHAVIORAL HEALTH CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
04070 | IL | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Behavioral Health Center, Inc | Doing Business As Name - Organization |
| 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 |
327 W PRAIRIE AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62522-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370299 | Julie Ann Marsh | Psychologist | 7120 W. William St., Decatur, IL 62522 | 2019-01-20 |
| 1588808323 | Paul D. Potter, D.d.s., Ltd | Dentist | 280 West North St, Decatur, IL 62522 | 2009-04-23 |
| 1801059100 | Melissa Ann Burnett | Dentist | 301 W North Street, Decatur, IL 62522 | 2008-07-07 |
| 1801060538 | Ronald James Grason | Internal Medicine | 357 W Decatur St, Decatur, IL 62522 | 2008-04-14 |
| 1033328349 | Jurgens & Kneezel Ltd | Dentist | 334 W Main Street, Decatur, IL 62522 | 2007-05-22 |
| 1740371905 | Randy Curtis Kneezel | Dentist | 334 W Main, Decatur, IL 62522 | 2006-09-27 |
| 1457373375 | Patricia Elaine Norton | Dentist | 1099 W Wood St, Suite E, Decatur, IL 62522 | 2006-07-24 |
| 1104883735 | Stephen J Chadwick | Otolaryngology | 101 W Mckinley Ave, Enta Allergy, Head & Neck Institute, Decatur, IL 62522 | 2006-04-27 |
| 1417408386 | Heritage Behavioral Health Center | Community/Behavioral Health | 955 N Main St, Decatur, IL 62522 | 2016-10-17 |
| 1467522466 | Alan Russell Jurgens | Dentist | 334 W Main, Decatur, IL 62522 | 2006-11-08 |
| Find all providers in zip 62522 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710518741 | Webster Cantrell Youth Advocacy | Clinic/Center | 202 E Eldorado St, Decatur, IL 62523-1039 | 2020-01-29 |
| 1245889609 | Sunshine Mental Wellness Inc | Clinic/Center | 2128 6th Ave Se Ste 501, Decatur, AL 35601-6563 | 2019-09-09 |
| 1760035455 | Come As You Are Counseling and Consulting LLC | Clinic/Center | 2042 Beltline Rd Sw Ste A120, Decatur, AL 35601-5691 | 2019-07-22 |
| 1225502057 | Crossing Recovery Center | Clinic/Center | 495 E. Central Ave, Decatur, IL 62521-4665 | 2019-01-15 |
| 1013491109 | Dayspring Counseling, LLC | Clinic/Center | 255 Grant St Se Ste 303, Decatur, AL 35601-2505 | 2018-09-24 |
| 1841739059 | Dr. Emily Katz Psychological Services | Clinic/Center | 1201 Clairmont Rd Ste 100, Decatur, GA 30030-1258 | 2017-02-21 |
| 1871971127 | L.i.n.k. Family Services | Clinic/Center | 3115 Sandlin Rd Sw, Decatur, AL 35603-1387 | 2015-05-07 |
| 1366719171 | Park Center, Inc. | Clinic/Center | 809 High St, Decatur, IN 46733-2324 | 2011-11-22 |
| 1356651582 | Brightpath Behavioral Health Group, L.L.C. | Clinic/Center | 2969 E Ponce De Leon Ave, Decatur, GA 30030-2215 | 2010-10-21 |
| 1043456908 | New Joshuas Circle of Hope for Mental Wellness & Recovery | Clinic/Center | 201 Thicket Way, Decatur, GA 30035-3700 | 2008-12-25 |
| 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.