| Community Resource Center Inc. | |
|
421 W Main St Vandalia IL 62471-2214 | |
| (618) 283-4229 | |
| (618) 533-0012 |
| Full Name | Community Resource Center Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 421 W Main St, Vandalia, 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 E. Martin Luther King Drive Centralia IL 62801-3506 Ph: (618) 533-1391 | Community Resource Center Inc. 421 W Main St Vandalia IL 62471-2214 Ph: (618) 283-4229 |
| NPI Number | 1245408491 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 12/17/2021 |
| Certification Date | 11/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245408491 | NPI | - | NPPES |
| A-00235-0004-A | Other | IL | DHS LICENSE NUMBER |
| 04035 | Medicaid | IL | |
| 6115207 | Other | IL | BLUE CROSS |
| A-00235-0003-A | Other | IL | DHS LICENSE NUMBER |
| A-00235-0002-A | Other | IL | DHS LICENSE NUMBER |
| A-00235-0001-A | Other | IL | DHS LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Ten Broeck Tennessee Physicians Group Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 N 8th St, Vandalia, IL 62471 Phone: 618-283-1731 Fax: 618-283-0590 | |
Illinois Associates In Psychiatry Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 N 8th St, Vandalia, IL 62471 Phone: 618-656-2000 | |
Community Resource Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 W Main St, Vandalia, IL 62471 Phone: 618-283-4229 Fax: 618-533-0012 | |
Illinois Associates Psychiary P C Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 W Taylor St, Vandalia, IL 62471 Phone: 618-656-2000 Fax: 618-656-1169 | |
Mcs Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1404 N 5th St, Vandalia, IL 62471 Phone: 618-283-2883 | |
Brighter Days Mental Health Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 716a E 1700 Ave, Vandalia, IL 62471 Phone: 618-214-4990 |