# HERITAGE ENTERPRISES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Enterprises, Inc. dba Green Tree Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780675488
- **Authorized official:** MR. DAVID M UNDERWOOD (SR. VP & CFO)
- **Authorized official phone:** (309) 828-4361

## Contact information

- **Practice address:** 700 E WALNUT ST, BLOOMINGTON, IL 61701-3244
- **Practice address phone:** (309) 829-1268
- **Practice address fax:** (309) 829-3475
- **Mailing address:** 115 W JEFFERSON ST, SUITE 401, BLOOMINGTON, IL 61701-3946
- **Mailing address phone:** (309) 828-4361
- **Mailing address fax:** (309) 829-9512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | -61702-17 | IL | Yes |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 07/21/2022