NPIMap

Organization Active NPI

Community Resource Center

  • Community/Behavioral Health Agency
  • Vandalia, IL
National Provider Identifier
1972771699
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY RESOURCE CENTER
Practice address
423 W Main
Vandalia, IL 62471
Phone
(618) 283-4229
Fax
(618) 533-0012
NPI assigned
Feb 15, 2008
Last updated
Feb 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Denise Daum
Title
Executive Director
Phone
(618) 533-1391

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

423 W Main
Vandalia, IL 62471

Mailing address

101 S Locust St
Centralia, IL 62801-3506
Phone (618) 533-1391

Other identifiers 2

IdentifierTypeStateIssuer
04035MedicaidIL
6115207OtherILBLUE CROSS

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

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1972771699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S LOCUST ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013506",
            "telephone_number": "618-533-1391",
            "fax_number": "618-533-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 W MAIN",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "62471",
            "telephone_number": "618-283-4229",
            "fax_number": "618-533-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "DAUM",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-533-1391"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04035",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6115207",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.