Organization Name: | CENTERVILLE CLINICS, INC PEER SUPPORT |
NPI Number: | 1851570055 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATTY MARTOS (DIRECTOR FINANCE/PERSONNEL) |
Mailing Address: | 1070 Old National Pike Fredericktown |
State: | PA US |
Postal Code: | 153332114 |
Phone Number: | 7246326801 |
Fax Number: | 7246326312 |
NPI Enumeration Date: | 10/24/2007 |
NPI Last Update Date: | 10/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |