# CENTERVILLE CLINICS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013999317
- **Authorized official:** MRS. PATRICIA MARTOS (DIRECTOR OF FINANCE/PERSONNEL)
- **Authorized official phone:** (724) 632-6801

## Contact information

- **Practice address:** 190 BONAR AVE, WAYNESBURG, PA 15370-1604
- **Practice address phone:** (724) 627-8156
- **Mailing address:** 1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
- **Mailing address phone:** (724) 632-6801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | Yes |
| 104100000X | Social Worker | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 11/14/2005
- **Last updated:** 07/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007288440003 | — | PA |