| Community Resource Center Inc. | |
|
904 East Martin Luther King Drive Centralia IL 62801 | |
| (618) 533-1391 | |
| (618) 533-0012 |
| Full Name | Community Resource Center Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 904 East Martin Luther King Drive, Centralia, Illinois |
| Authorized Official Name and Position | Georgianne Broughton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6185331391 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Resource Center Inc. 904 East Martin Luther King Drive Centralia IL 62801 Ph: (618) 533-1391 | Community Resource Center Inc. 904 East Martin Luther King Drive Centralia IL 62801 Ph: (618) 533-1391 |
| NPI Number | 1629204888 |
|---|---|
| Provider Enumeration Date | 06/02/2009 |
| Last Update Date | 04/26/2023 |
| Certification Date | 04/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629204888 | NPI | - | NPPES |
| 04035 | Medicaid | IL | |
| 671700 | Other | IL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Community Resource Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 904 E Mlk Drive, Centralia, IL 62801 Phone: 618-533-1301 Fax: 618-533-0012 | |
Ssm Health St. Mary's Hospital - Centralia Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 400 N Pleasant Ave, Centralia, IL 62801 Phone: 618-436-8000 | |
Ssm Health St. Mary's Hospital - Centralia Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 400 N Pleasant Ave, Centralia, IL 62801 Phone: 618-436-8000 | |
Community Resource Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 S Locust St, Centralia, IL 62801 Phone: 618-533-1391 Fax: 618-533-0012 | |
Community Resource Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 904 E. Martin Luther King Drive, Centralia, IL 62801 Phone: 618-533-1391 Fax: 618-533-0012 | |
Progressive Life Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Airport Rd, Centralia, IL 62801 Phone: 618-316-3826 | |
Carbondale Beh. Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1034 E Noleman St, Centralia, IL 62801 Phone: 618-436-6267 |