Clarksburg Treatment Center, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

CLARKSBURG TREATMENT CENTER, LLC

Practice address

706 Oakmound Rd
Clarksburg, WV 26301-9398

Phone

(304) 622-7511

Fax

(304) 622-6856

NPI assigned

Dec 4, 2017

Organization subpart

Yes

Parent organization

ACADIA HEALTHCARE COMPANY, INCAs reported in NPPES

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

Authorized official

Name

Brian Phillip Farley

Title

VP & Secretary

Phone

(615) 861-6000

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Clarksburg Treatment Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clarksburg, WV
  • NPI 1013029156

  9931534245

  Same PAC ID

Tax ID family

Clarksburg Treatment Center LLC3 organizations share this tax ID, including this one

Part of

Haven Behavioral Healthcare

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Clarksburg Treatment Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clarksburg, WV
  • NPI 1013029156
  NPD tax ID
• Clarksburg Treatment Center, LLC

  • Methadone Clinic
  • Clarksburg, WV
  • NPI 1619379559
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Gifford Street Wellness Center, LLC

  • Methadone Clinic
  • New Bedford, MA
  • NPI 1568078327

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1124533930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 PASEO DEL NORTE STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111155",
            "telephone_number": "855-259-2288",
            "fax_number": "877-552-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 OAKMOUND RD",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019398",
            "telephone_number": "304-622-7511",
            "fax_number": "304-622-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSBURG TREATMENT CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA HEALTHCARE COMPANY, INC",
        "enumeration_date": "2017-12-04",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clarksburg SNF LLC
• Clarksburg Treatment Center, LLC
• Clarksburg Treatment Center, LLC
• Clarksburg Vamc
• Clarksburg Vamc
• Clarksburg Vamc
• Gregory Clevenger

• Methadone Clinic in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Methadone Clinic in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.