Community Resource Center Inc.

LBN: Community Resource Center Inc.
Community Resource Center Inc. is an health care organization with primary practice located at 904 E. Martin Luther King Drive , Centralia IL 62801-6280. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Community Resource Center Inc. can be contacted via phone (618) 533-1391, or through Broughton, Georgianne via phone (618) 533-1391.

Contact Information

Primary practice address
904 E. Martin Luther King Drive Centralia IL 62801-6280
Phone: (618) 533-1391
Fax: (618) 533-0012
Website:
Map and Directions
Authorized official contact:
Name: Broughton, Georgianne
Phone: (618) 533-1391

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 04035 Illinois

Profile Details

NPI number 1518246776
LBN Legal business name Community Resource Center Inc.
DBA Doing business as
Authorized official Broughton, Georgianne
Entity Organization
Organization subpart 1 No
Enumeration date Aug 5th, 2011
Last updated Dec 21st, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518246776 NPPES
Illinois MEDICAID 04035

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