| Crossing Healthcare At Heritage Behavioral Health Center | |
|
151 N Main St Decatur IL 62523-1206 | |
| (217) 420-4709 | |
| Not Available |
| Full Name | Crossing Healthcare At Heritage Behavioral Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 151 N Main St, Decatur, Illinois |
| Authorized Official Name and Position | Thomas L West (FINANCE DIRECTOR / CFO) |
| Authorized Official Contact | 2178776127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossing Healthcare At Heritage Behavioral Health Center 320 E Central Ave Decatur IL 62521-4665 Ph: (217) 877-9117 | Crossing Healthcare At Heritage Behavioral Health Center 151 N Main St Decatur IL 62523-1206 Ph: (217) 420-4709 |
| NPI Number | 1164778031 |
|---|---|
| Provider Enumeration Date | 07/30/2012 |
| Last Update Date | 05/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164778031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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