COMMUNITY RESOURCE CENTER (NPI# 1295903912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295903912 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RESOURCE CENTER |
| Practice Address |
519 S Locust St Centralia IL 62801 |
| Mailing Address |
904 E. Martin Luther King Drive Centralia IL 62801-3506 |
| Practice Telephone | 6185331391 |
| Practice Fax Number | 6185330012 |
| Mailing Telephone | 6185331391 |
| Mailing Fax Number | 6185330012 |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | GEORGIANNE BROUGHTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6185331391 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 04035 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063765055 | Community Resource Center | Community/Behavioral Health | 904 E Mlk Drive, Centralia, IL 62801-3058 | 2012-10-16 |
| 1972771699 | Community Resource Center | Community Based Residential Treatment Facility, Mental Illness | 423 W Main, Vandalia, IL 62471 | 2008-02-15 |
| 1740458462 | Community Resource Center | Clinic/Center | 867 Mlk Drive, Centralia, IL 62801-5618 | 2008-02-15 |
| 1225434855 | Community Resource Center | Case Management | 650 2nd Street, Encinitas, CA 92024 | 2014-11-10 |
| 1518246776 | Community Resource Center | Community/Behavioral Health | 101 S Locust St, Centralia, IL 62801-3506 | 2011-08-05 |
| 1871896936 | Community Resource Center | Community/Behavioral Health | 101 S Locust St, Centralia, IL 62801-3506 | 2010-12-13 |
| 1184850349 | Community Resource Center | Clinic/Center | 421 W Main St, Vandalia, IL 62471-2214 | 2009-06-02 |
| 1629204888 | Community Resource Center | Clinic/Center | 904 East Martin Luther King Drive, Centralia, IL 62801 | 2009-06-02 |
| 1538395793 | Community Resource Center | Clinic/Center | 580 8th St, Carlyle, IL 62231-1803 | 2009-06-02 |
| 1487822102 | Community Resource Center | Clinic/Center | 425 W Main St, Vandalia, IL 62471-2214 | 2008-02-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY RESOURCE CENTER | 913 Webster St, Chillicothe, MO 64601-2241 |
| Oregon Corporations, Companies and Business Names | COMMUNITY RESOURCE CENTER | 10153 Mill Creek Rd, Aumsville, OR 97325 |
| New York State Corporations | COMMUNITY RESOURCE CENTER FOR THE DEVELOPMENTALLY DISABLED, INC. | 1776 Eastchester Rd. Suite 225, Bronx, New York 10461 |
| System for Award Management (SAM) Entities | COMMUNITY RESOURCE CENTER INC | 904 M L King Dr, Centralia, IL 62801-3058 |
| System for Award Management (SAM) Entities | COMMUNITY RESOURCE CENTER OF JOHNSON COUNTY | 63 N Burritt Ave Ste 101a, Buffalo, WY 82834-1868 |
| Street Address |
519 S LOCUST ST |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740458462 | Community Resource Center | Clinic/Center | 867 Mlk Drive, Centralia, IL 62801-5618 | 2008-02-15 |
| 1538658372 | Progressive Life Counseling, LLC | Clinic/Center | 515 Airport Rd, Centralia, IL 62801-6583 | 2018-05-07 |
| 1447651625 | Elaine Pichette Np & Associates Pllc | Clinic/Center | 1000 Kresky Ave, Suite G, Centralia, WA 98531-3700 | 2014-09-08 |
| 1629204888 | Community Resource Center | Clinic/Center | 904 East Martin Luther King Drive, Centralia, IL 62801 | 2009-06-02 |
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|---|---|---|---|---|
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| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.