Organization
COMMUNITY RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON LEWIS FARLEY MA (MENTAL HEALTH WORKER)
(618) 533-0012
Entity
Organization
Contact information
Practice address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 267-1735
Mailing address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 267-1735
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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