Provider Demographics
NPI:1427273911
Name:CENTER FOR COMMUNITY RESOURCES, INC.
Entity type:Organization
Organization Name:CENTER FOR COMMUNITY RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:724-431-0095
Mailing Address - Street 1:127 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5935
Mailing Address - Country:US
Mailing Address - Phone:724-431-0095
Mailing Address - Fax:724-431-0099
Practice Address - Street 1:212 - 214 S. MAIN ST
Practice Address - Street 2:SUITE 625
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5914
Practice Address - Country:US
Practice Address - Phone:724-431-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007491000004Medicaid
PA1007491000006Medicaid
PA1007491000020Medicaid
PA1007491000013Medicaid