| Community Resource Center, Inc | |
|
315 Westgate Salem IL 62881 | |
| (618) 548-2181 | |
| (618) 548-1035 |
| Full Name | Community Resource Center, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 315 Westgate, Salem, 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 62801-3058 Ph: (618) 533-1391 | Community Resource Center, Inc 315 Westgate Salem IL 62881 Ph: (618) 548-2181 |
| NPI Number | 1770718439 |
|---|---|
| Provider Enumeration Date | 05/26/2009 |
| Last Update Date | 01/03/2020 |
| Certification Date | 01/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770718439 | NPI | - | NPPES |
| 04035 | Medicaid | IL | |
| 671700 | Other | IL | MEDICARE |
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