Provider Demographics
NPI:1447784624
Name:COMMUNITY RESOURCE & COUNSELING CENTER
Entity Type:Organization
Organization Name:COMMUNITY RESOURCE & COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROPEK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-379-4302
Mailing Address - Street 1:1510 W OTTAWA RD
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:IL
Mailing Address - Zip Code:60957-4090
Mailing Address - Country:US
Mailing Address - Phone:217-379-4302
Mailing Address - Fax:217-379-4304
Practice Address - Street 1:1510 W OTTAWA RD
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:IL
Practice Address - Zip Code:60957-4090
Practice Address - Country:US
Practice Address - Phone:217-379-4302
Practice Address - Fax:217-817-0379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA76520001A261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILA7652001AOtherDIVISION OF ALCOHOLISM AND SUBSTANCE ABUSE