MEDICARE: CENTER FOR COMMUNITY RESOURCES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251K00000X	Public Health or Welfare Agency
3	261Q00000X	Clinic/Center
4	251S00000X	Community/Behavioral Health Agency	442680	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	497401	OTHER	PA	VALUE BEHAVIORAL HEALTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417095472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR COMMUNITY RESOURCES, INC.

Provider Business Mailing Address
First Line	:	127 S MAIN ST
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-5935
Country	:	US
Telephone Number	:	724-431-0095
Fax Number	:	724-431-0099

Provider Business Practice Location Address
First Line	:	212 - 214 SOUTH MAIN STREET
Second Line	:	SUITE 625
City	:	BUTLER
State	:	PA
Zip	:	16001-5987
Country	:	US
Telephone Number	:	724-431-0095
Fax Number	:	724-431-0099

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MICHAEL P ROBB
Credential	:	MA
Telephone Number	:	724-431-0095

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	10/18/2023

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