| Community Resource Center Inc. | |
|
904 E Mlk Drive Centralia IL 62801-3058 | |
| (618) 533-1301 | |
| (618) 533-0012 |
| Full Name | Community Resource Center Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 904 E Mlk Drive, Centralia, Illinois |
| Authorized Official Name and Position | Georgianne Broughton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6185330012 |
| 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 Dr. Centralia IL 62801-3058 Ph: (618) 533-1301 | Community Resource Center Inc. 904 E Mlk Drive Centralia IL 62801-3058 Ph: (618) 533-1301 |
| NPI Number | 1063765055 |
|---|---|
| Provider Enumeration Date | 10/16/2012 |
| Last Update Date | 12/17/2021 |
| Certification Date | 11/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063765055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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