ST MARYS SQUARE LIVING CENTER
NPI 1114140373
Intermediate Care Facility, Intellectual Disabilities in Galesburg, IL

Q: What is Community Residential Centers Inc's NPI number?

The NPI number for Community Residential Centers Inc is 1114140373. It was assigned to this organization in the NPPES registry on April 10, 2007. The provider is doing business as St Marys Square Living Center.

Q: What is Community Residential Centers Inc's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since April 10, 2007

239 S CHERRY STREET, GALESBURG, IL 61401(309) 343-4101(309) 343-4106 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About St Marys Square Living Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST MARYS SQUARE LIVING CENTER (NPI 1114140373) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Galesburg, Illinois and active in the NPI registry since April 2007. The organization lists Bobby D Dillard, Administrator, as its authorized official.

NPPES Registry Identity

NPI1114140373

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameCOMMUNITY RESIDENTIAL CENTERS INC

Location Address239 S CHERRY STREETGalesburg, IL 61401

Mailing Address239 S Cherry StreetGalesburg, IL 61401 · (309) 343-4101 · Fax (309) 343-4106

Phone(309) 343-4101

Fax(309) 343-4106

Organization SubpartNo

Authorized OfficialBobby D DillardAdministrator · (309) 343-4101

Enumeration DateApril 10, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1114140373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

License✔ Licensed in IL · 003406

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

239 S CHERRY STREET, Galesburg, IL 61401

Open in Google Maps ↗

Other Names 1

Doing Business AsSt Marys Square Living Center

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Community Residential Centers Inc's NPI number?

The NPI number for Community Residential Centers Inc is 1114140373. It was assigned to this organization in the NPPES registry on April 10, 2007. The provider is doing business as St Marys Square Living Center.

Where is Community Residential Centers Inc located?

Community Residential Centers Inc is located at 239 S Cherry Street, Galesburg, IL 61401. The listed phone number is (309) 343-4101.

What is Community Residential Centers Inc's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Community Residential Centers Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.