St Marys Square Living Center

LBN: Community Residential Centers Inc
St Marys Square Living Center is an health care organization with primary practice located at 239 South Cherry Street , Galesburg IL 61401-4911. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Community Residential Centers Inc can be contacted via phone (309) 343-4101, or through Wilson, Ronald J via phone (309) 343-1550.

Contact Information

Primary practice address
239 South Cherry Street Galesburg IL 61401-4911
Phone: (309) 343-4101
Fax: (309) 343-4118
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Ronald J
Phone: (309) 343-1550

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 34066 Illinois

Profile Details

NPI number 1043482979
LBN Legal business name Community Residential Centers Inc
DBA Doing business as St Marys Square Living Center
Authorized official Wilson, Ronald J
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 1st, 2008
Last updated Apr 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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