Organization
CENTERVILLE CLINICS, INC BLENDED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY MARTOS (DIRECTOR PERSONNEL AND FINANCE)
(724) 632-6801
Entity
Organization
Contact information
Practice address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440012
—
PA
01
—
328834A336347
VALUE BEHAVIORAL HEALTH
PA
Enumeration date
02/27/2008
Last updated
03/07/2008
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