# CENTERVILLE CLINICS, INC.

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

## Provider details

- **NPI number:** 1497923635
- **Authorized official:** MRS. PATRICIA MARTOS (DIRECTOR PERSONNEL AND FINANCE)
- **Authorized official phone:** (724) 632-6801

## Contact information

- **Practice address:** 27 HIGHLAND AVE, WASHINGTON, PA 15301-4061
- **Practice address phone:** (724) 223-1067
- **Practice address fax:** (724) 228-8421
- **Mailing address:** 1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
- **Mailing address phone:** (724) 632-6801
- **Mailing address fax:** (724) 632-6312

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 02/11/2008
- **Last updated:** 12/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007288440089 | — | PA |