Organization
CENTERVILLE CLINICS, INC BLENDED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY MARTOS (DIRECTOR FINANCE/PERSONNEL)
(724) 632-6801
Entity
Organization
Contact information
Practice address
601 W GEORGE ST, CARMICHAELS, PA 15320-1325
(724) 966-5081
(724) 966-9002
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440093
—
PA
01
—
328834A764918
VALUE BEHAVIOR HEALTH
PA
Enumeration date
01/08/2008
Last updated
01/08/2008
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