Community Resource Center Inc.
Organization Active NPI Community/Behavioral Health Agency · Centralia, IL
NPI 1518246776 · NPPES record last updated Dec 21, 2021
Key facts
- NPI
- 1518246776
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 04035 (IL)
- Legal business name
- COMMUNITY RESOURCE CENTER INC.
- Practice address
- 904 E. Martin Luther King Drive
Centralia, IL 62801-6280 - Phone
- (618) 533-1391
- Fax
- (618) 533-0012
- NPI assigned
- Aug 5, 2011
- Organization subpart
- No
Authorized official
- Name
- Mrs. Georgianne Broughton
- Title
- Executive Director
- Phone
- (618) 533-1391
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Community Resource CNTR
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 04035 | IL | Yes |
Addresses
Primary practice location
904 E. Martin Luther King Drive
Centralia, IL 62801-6280
Mailing address
101 S Locust St
Centralia, IL 62801-3506
Phone (618) 533-1391
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04035 | Medicaid | IL |
Other providers in Centralia, IL
- Community Resource Center
- Community Resource Center Inc
- Community Resource Center Inc.
- Community Resource Center Inc.
- Community Resource Center Inc.
- Community Resource Center Inc.
- Reagen Coridon Conklin
- Jose Cortes
- Matthew Crawford
- Critter Chiropractic Inc.
All providers in Centralia, IL · Community/Behavioral Health Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.