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 S Cherry Street , Galesburg IL 61401. 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 Dillard, Bobby D via phone (309) 343-4101.

Contact Information

Primary practice address
239 S Cherry Street Galesburg IL 61401
Phone: (309) 343-4101
Fax: (309) 343-4106
Website:
Map and Directions
Authorized official contact:
Name: Dillard, Bobby D MS LNHA
Phone: (309) 343-4101

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 003406 Illinois

Profile Details

NPI number 1114140373
LBN Legal business name Community Residential Centers Inc
DBA Doing business as St Marys Square Living Center
Authorized official Dillard, Bobby D MS LNHA
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2007
Last updated Aug 22nd, 2020 - about 4 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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