{
  "npi": "1770718439",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "LPHA, LCPC",
    "authorized_official_first_name": "GEORGIANNE",
    "authorized_official_last_name": "BROUGHTON",
    "authorized_official_telephone_number": "6185331391",
    "authorized_official_title_or_position": "Executive Director",
    "certification_date": "2020-01-03",
    "enumeration_date": "2009-05-26",
    "last_updated": "2020-01-03",
    "organization_name": "COMMUNITY RESOURCE CENTER, INC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "904 E MARTIN LUTHER KING DRIVE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CENTRALIA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "618-533-0012",
      "postal_code": "628013058",
      "state": "IL",
      "telephone_number": "618-533-1391"
    },
    {
      "address_1": "315 WESTGATE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "SALEM",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "618-548-1035",
      "postal_code": "62881",
      "state": "IL",
      "telephone_number": "618-548-2181"
    }
  ],
  "taxonomies": [
    {
      "code": "251S00000X",
      "desc": "Community/Behavioral Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM0801X",
      "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "B4[14]",
        "medicare_type": "Community Mental Health Center"
      }
    ]
  }
}