Goldwater Estates of Clinton LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOLDWATER ESTATES OF CLINTON LLC

Doing business as

Goldwater Estates of Clinton

Practice address

1 Park LN W
Clinton, IL 61727-2637

Phone

(217) 935-8500

NPI assigned

Feb 4, 2025

Last updated

Sep 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Spector

Title

VP of Revenue Cycle Management

Phone

(847) 262-3800

Specialties & licenses 1

Addresses

Other names 1

• Goldwater Estates of Clinton Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1508670126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 W CHASE AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121605",
            "telephone_number": "847-262-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK LN W",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272637",
            "telephone_number": "217-935-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDWATER ESTATES OF CLINTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "SPECTOR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "847-262-3800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Goldwater Estates of Clinton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Goldwater Care Clinton LLC (Goldwater Care Clinton)
• Mykenzie A Green, NBC-HWC
• Megan Marie Hanson, M.S. CCC-SLP
• Kevin Edward Hegi
• Heritage Behavioral Health Center
• Heritage Behavioral Health Center, Inc.

• Assisted Living Facility in Clinton, IL
• Providers in Clinton, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.