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Organization
CENTERVILLE CLINICS, INC.
Active
Organization
CENTERVILLE CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA MARTOS (DIRECTOR OF FINANCE/PERSONNEL)
(724) 632-6801
Entity
Organization
Contact information
Practice address
190 BONAR AVE, WAYNESBURG, PA 15370-1604
(724) 627-8156
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
104100000X
Social Worker
Primary
—
NULL
104100000X
Social Worker
Primary
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440003
—
PA
Enumeration date
11/14/2005
Last updated
07/22/2010
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