NPIMap

Organization Active NPI

Centerville Clinics, Inc.

  • Case Manager/Care Coordinator
  • California, PA
National Provider Identifier
1013193713
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
CENTERVILLE CLINICS, INC.
Practice address
1152 Wood St
California, PA 15419-1260
Phone
(724) 938-2099
Fax
(724) 938-3221
NPI assigned
Jan 14, 2008
Last updated
Aug 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Patty Martos
Title
Director Finance and Personnel
Phone
(724) 632-6801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

1152 Wood St
California, PA 15419-1260

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other identifiers 2

IdentifierTypeStateIssuer
1007288440095MedicaidPA
328834A336351OtherPAVALUE BEHAVIORAL HEALTH

National Provider Directory

National Provider Directory
Tax ID family
Centerville Clinics Inc66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1013193713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1152 WOOD ST",
            "city": "CALIFORNIA",
            "state": "PA",
            "postal_code": "154191260",
            "telephone_number": "724-938-2099",
            "fax_number": "724-938-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "MARTOS",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "DIRECTOR FINANCE AND PERSONNEL",
        "authorized_official_telephone_number": "724-632-6801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440095",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE BEHAVIORAL HEALTH",
            "identifier": "328834A336351",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in California, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.