COMMUNITY RESOURCE CENTER INC (NPI# 1932377652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932377652 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RESOURCE CENTER INC |
| Practice Address |
315 Westgate Ave Salem IL 62881 |
| Mailing Address |
101 S Locust St Centralia IL 62801-3506 |
| Practice Telephone | 6185482181 |
| 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 | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DHS LICENSE NUMBER | A-00235-0003-A | 01 |
| IL | DHS LICENSE NUMBER | A-00235-0004-A | 01 |
| IL | BLUE CROSS | 6115207 | 01 |
| IL | 04035 | 05 | |
| IL | DHS LICENSE NUMBER | A-00235-0002-A | 01 |
| IL | DHS LICENSE NUMBER | A-00235-0001-A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386605434 | Community Resource Center Inc | Clinic/Center | 904 East Martin Luther King Drive, Centralia, IL 62801 | 2006-03-29 |
| 1154599884 | Community Resource Center Inc | Clinic/Center | 580 8th St, Carlyle, IL 62231-1803 | 2008-02-15 |
| 1841468568 | Community Resource Center Inc | Community/Behavioral Health | 904 East Martin Luther King Drive, Centralia, IL 62801 | 2008-02-15 |
| 1245408491 | Community Resource Center Inc | Clinic/Center | 421 W Main St, Vandalia, IL 62471-2214 | 2008-02-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY RESOURCE CENTER INC | 904 M L King Dr, Centralia, IL 62801-3058 |
| Virginia Business Entities | Community Resource Center Inc. | Po Box 1572, Harrisonburg, Virginia 22803-1572 |
| Street Address |
315 WESTGATE AVE |
| City | SALEM |
| State | IL |
| Zip Code | 62881 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447776026 | Heather Krajefska | Speech-Language Pathologist | Franklin Park School, 1325 N Franklin, Salem, IL 62881 | 2017-08-16 |
| 1629510581 | Heidi V. Thompson | Nurse Practitioner | 1250 W. Whittaker, Salem, IL 62881 | 2016-11-09 |
| 1548664170 | Catherine Durbin | Nurse Practitioner | 518 South Broadway, Salem, IL 62881 | 2014-10-10 |
| 1770718439 | Community Resource Center, Inc | Community/Behavioral Health | 315 Westgate, Salem, IL 62881 | 2009-05-26 |
| 1245408053 | The Manor At Salem Woods, L.p. | Assisted Living Facility | 441 S. Hotze Rd., Salem, IL 62881 | 2008-02-14 |
| 1366610321 | Penta Group Inc. | Non-emergency Medical Transport (VAN) | 300 Schoonover Drive, Salem, IL 62881 | 2008-02-13 |
| 1326192808 | Alan D Montgomery | Optometrist | 400 North Broadway, Salem, IL 62881 | 2007-01-22 |
| 1669539979 | Knevitt Inc | Ambulance | 3340 Selmaville Rd, Salem, IL 62881 | 2007-01-03 |
| 1447314737 | Gautam Jha | Internal Medicine | 1325 W. Whittaker, Suite D, Salem, IL 62881 | 2006-12-20 |
| 1235204322 | Imaging Center of Salem, Inc | Internal Medicine | 1325d W Whittaker St, Salem, IL 62881 | 2006-11-22 |
| Find all providers in zip 62881 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1578528915 | Pacific Recovery Inc | Clinic/Center | 1235 Woodrow Ne, Salem, OR 97303 | 2006-04-19 |
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| 1104163658 | Services To Overcome Drug Abuse Among Teenagers | Clinic/Center | 75 Market St, Salem, NJ 08079-1918 | 2013-01-03 |
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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.