COMMUNITY RESOURCE CENTER INC. – NPI #1386605434
Clinic/Center

COMMUNITY RESOURCE CENTER INC. is an AHC clinic located in CENTRALIA, IL. NPPES has assigned the NPI number 1386605434 to COMMUNITY RESOURCE CENTER INC. on March 29, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is CENTRAL COMPREHENSIVE MENTAL HEALTH CENTER. The primary taxonomy selected by this provider is 261QR0405X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rehabilitation, Substance Use Disorder

The NPI profile was previously updated about 4 years ago on Dec 17, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COMMUNITY RESOURCE CENTER INC. below.

NPI Profile for
COMMUNITY RESOURCE CENTER INC.

NPI Number
1386605434
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COMMUNITY RESOURCE CENTER INC.
Former Legal Business Name: CENTRAL COMPREHENSIVE MENTAL HEALTH CENTER
Primary location
904 EAST MARTIN LUTHER KING DRIVE
CENTRALIA, IL 62801
Phone: (618) 533-1391 Fax: (618) 533-0012
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
GEORGIANNE BROUGHTON
EXECUTIVE DIRECTOR
Phone: (618) 533-1391
Updated
Certification Date
Nov 12, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for COMMUNITY RESOURCE CENTER INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIL04035
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR0405X
- Clinic/Center / Rehabilitation, Substance Use Disorder (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.