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HEARTLAND BANYAN LLC NPI 1215404819


NPI Information

NPI: 1215404819
Provider Name: HEARTLAND BANYAN, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 14D2158927

Address:
1237 E 1600 NORTH RD
GILMAN, IL
ZIP 60938
Phone: (888) 879-4975
Get Directions

HEARTLAND BANYAN, LLC is a substance abuse rehabilitation facility in Gilman, IL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. HEARTLAND BANYAN, LLC NPI is 1215404819. The provider is registered as an organization entity type.

The provider's business location address is:

1237 E 1600 NORTH RD
GILMAN, IL
ZIP 60938-112
Phone: (888) 879-4975
Fax: (954) 781-7173

The provider's authorized official is Rene Molina .
The authorized official title is Director Of Credentialing & Contrac and has the following contact phone number (954) 533-7705.

The CLIA number assigned to this NPI record is 14D2158927 - other - substance abuse treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2018 and was last updated on 2/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1283Q00000XPsychiatric HospitalNo
2324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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