NPIMap

Organization Active NPI

Heritage Behavioral Health Center Inc.

  • Primary Care Clinic/Center
  • Decatur, IL
National Provider Identifier
1104609544
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HERITAGE BEHAVIORAL HEALTH CENTER INC.
Practice address
243 W Cerro Gordo St
Decatur, IL 62522-2101
Phone
(217) 422-3940
NPI assigned
Aug 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Garrison, LCSWNPI 1598073959
Title
Ceo
Phone
(217) 362-6262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

243 W Cerro Gordo St
Decatur, IL 62522-2101

Mailing address

151 N Main St
Decatur, IL 62523-1206
Phone (217) 362-6262

National Provider Directory

National Provider Directory
Tax ID family
Heritage Behavioral Health14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 53

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1104609544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "217-362-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 W CERRO GORDO ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625222101",
            "telephone_number": "217-422-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE BEHAVIORAL HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-362-6262",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.