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COMMUNITY RESOURCE CENTER INC.
NPI 1629204888
Clinic/Center - Mental Health (Including Community Mental Health Center) in Centralia, IL

Active since June 02, 2009
904 EAST MARTIN LUTHER KING DRIVE, CENTRALIA, IL 62801(618) 533-1391(618) 533-0012 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 17, 2021, Jul 12, 2018 (2 updates tracked since 2018).

About Community Resource Center Inc. NPPES

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

COMMUNITY RESOURCE CENTER INC. (NPI 1629204888) is a healthcare organization registered as a mental health (including community mental health center) in Centralia, Illinois and active in the NPI registry since June 2009. The organization lists Georgianne Broughton, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1629204888
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameCOMMUNITY RESOURCE CENTER INC.
Location Address904 EAST MARTIN LUTHER KING DRIVECentralia, IL 62801
Mailing Address904 East Martin Luther King DriveCentralia, IL 62801 · (618) 533-1391 · Fax (618) 533-0012
Phone(618) 533-1391
Fax(618) 533-0012
Organization SubpartNo
Authorized OfficialGeorgianne BroughtonExecutive Director · (618) 533-1391
Enumeration DateJune 2, 2009
Last NPPES UpdateApril 26, 20232 updates tracked since enumeration
NPPES CertifiedApril 26, 2023
✔ NPI 1629204888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
904 EAST MARTIN LUTHER KING DRIVE, Centralia, IL 62801
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Other Identifiers 2

Medicaid04035IL
Other671700IL · Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Community Resource Center Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Community Resource Center Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Stephanie Pitt, RDN, LPC
Registered Dietitian or Nutrition Professional
NPI 1871047217
904 E MARTIN LUTHER KING DRIVE
Centralia, IL 62801
(618) 533-1391
Same address
Angela Betters, DNP, APRN, PMHNP
Nurse Practitioner
NPI 1295442325
1201 RICKER RD
Salem, IL 62881
(618) 594-3194
✔ PECOS✔ Accepts Medicare13 mi
Tara Fleeman
Nurse Practitioner
NPI 1124838065
1201 RICKER RD
Salem, IL 62881
(618) 548-3194
✔ PECOS✔ Accepts Medicare13 mi
Alexa Wurm, PMHNP-BC
Nurse Practitioner
NPI 1508605197
1201 RICKER RD
Salem, IL 62881
(618) 975-4621
✔ PECOS✔ Accepts Medicare13 mi
Diana Tomlianovich, PMHNP-BC
Nurse Practitioner
NPI 1497288492
2920 VETERANS MEMORIAL DR
Mount Vernon, IL 62864
(618) 244-6544
✔ PECOS✔ Accepts Medicare19 mi
Sandra Tate, APN, PMNCNS-BC
Nurse Practitioner
NPI 1326093493
3412 OFFICE PARK DR
Marion, IL 62959
(618) 292-9999
✔ PECOS55 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Resource Center Inc.'s NPI number?

The NPI number for Community Resource Center Inc. is 1629204888. It was assigned to this organization in the NPPES registry on June 2, 2009.

Where is Community Resource Center Inc. located?

Community Resource Center Inc. is located at 904 East Martin Luther King Drive, Centralia, IL 62801. The listed phone number is (618) 533-1391.

What is Community Resource Center Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Community Resource Center Inc. enrolled in Medicare?

Yes. Community Resource Center Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Community Resource Center Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Community Resource Center Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5) and Registered Dietitian or Nutrition Professional (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Community Resource Center Inc. accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Community Resource Center Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Community Resource Center Inc. was last updated on April 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.