| Organization Name: | CLARKSBURG TREATMENT CENTER |
| NPI Number: | 1013029156 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHIL HERSCHMAN (CLINIC DIRECTOR) |
| Mailing Address: | 706 Oakmound Rd Clarksburg |
| State: | WV US |
| Postal Code: | 263019398 |
| Phone Number: | 3046227511 |
| Fax Number: | 3046227885 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 06/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2800X |
| License Number: | 03 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Methadone Clinic |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |