Organization
COMMUNITY RESOURCE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIANNE BROUGHTON (EXECUTIVE DIRECTOR)
(618) 533-1391
Entity
Organization
Contact information
Practice address
315 WESTGATE AVE, SALEM, IL 62881
(618) 548-2181
(618) 533-0012
Mailing address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 533-1391
(618) 533-0012
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04035
—
IL
01
—
6115207
BLUE CROSS
IL
01
—
A-00235-0001-A
DHS LICENSE NUMBER
IL
01
—
A-00235-0002-A
DHS LICENSE NUMBER
IL
01
—
A-00235-0003-A
DHS LICENSE NUMBER
IL
01
—
A-00235-0004-A
DHS LICENSE NUMBER
IL
Enumeration date
02/15/2008
Last updated
07/12/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us