NPIMap

Organization Active NPI

Community Resource Center Inc.

  • Community/Behavioral Health Agency
  • Centralia, IL
National Provider Identifier
1063765055
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY RESOURCE CENTER INC.
Practice address
904 E MLK Drive
Centralia, IL 62801-3058
Phone
(618) 533-1301
Fax
(618) 533-0012
NPI assigned
Oct 16, 2012
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Mrs. Georgianne Broughton
Title
Executive Director
Phone
(618) 533-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

904 E MLK Drive
Centralia, IL 62801-3058

Mailing address

904 E. Martin Luther King Dr.
Centralia, IL 62801-3058
Phone (618) 533-1301

National Provider Directory

National Provider Directory
Tax ID family
Community Resource Ctr Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1063765055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 E. MARTIN LUTHER KING DR.",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013058",
            "telephone_number": "618-533-1301",
            "fax_number": "618-533-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 E MLK DRIVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013058",
            "telephone_number": "618-533-1301",
            "fax_number": "618-533-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESOURCE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2021-12-17",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "GEORGIANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-533-0012",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.