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General NPI Number Information
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NPI Number | 1699645390
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Entity Type | Organization
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Legal Business Name | HERITAGE BEHAVIORAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 140 SUNRISE CT
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City | CLINTON
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State | IL
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Zip | 61727-9906
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Country | US
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Telephone | 217-570-0900
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Fax | 217-362-6290
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Provider Business Mailing Address
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Address Line | 140 SUNRISE CT
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City | CLINTON
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State | IL
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Zip | 61727-9906
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Country | US
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Telephone | 217-570-0900
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Fax | 217-362-6290
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Authorized Official
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Title or Position | CEO
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Name | MARY GARRISON
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Credential | LCSW
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Telephone | 217-420-4779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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