Charleston Treatment Center, LLC.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CHARLESTON TREATMENT CENTER, LLC.

Practice address

2157 Greenbrier St
Charleston, WV 25311-9623

Phone

(304) 344-5924

Fax

(304) 344-3503

NPI assigned

Aug 3, 2006

Organization subpart

Yes

Parent organization

ACADIA HEALTHCARE COMPANY, INC.As 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Charleston Treatment Center, LLC

  • Methadone Clinic
  • Charleston, WV
  • NPI 1720480668

  O20200107003060, O20230301001764

  Same enrollment
• Charleston Treatment Center, LLC

  • Methadone Clinic
  • Charleston, WV
  • NPI 1861906687

  O20200107003060

  Same enrollment

Tax ID family

Charleston 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.

• Charleston Treatment Center, LLC

  • Methadone Clinic
  • Charleston, WV
  • NPI 1720480668
  NPD tax ID
• Charleston Treatment Center, LLC

  • Methadone Clinic
  • Charleston, WV
  • NPI 1861906687
  NPD tax ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bobbie Jo Burdette

  • Family Nurse Practitioner
  • Given, WV
  • NPI 1174088058
  NPD
• Connie Fay Dorfner, PA-C

  • Medical Physician Assistant
  • South Charleston, WV
  • NPI 1407006323
  NPD (past)
• Carolyn S Frye, RN,MSN,FNP-BC

  • Family Nurse Practitioner
  • Charleston, WV
  • NPI 1285919712
  NPD (past)
• David H. Lynch, D.O.

  • General Practice Physician
  • Trion, GA
  • NPI 1417996455
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1255349726",
    "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": "2157 GREENBRIER ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253119623",
            "telephone_number": "304-344-5924",
            "fax_number": "304-344-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON TREATMENT CENTER, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA HEALTHCARE COMPANY, INC.",
        "enumeration_date": "2006-08-03",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "WV",
            "license": "02",
            "primary": false
        }
    ],
    "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": []
}

• Charleston Surgical Hospital Healthcare Group, PLLC
• Charleston Surgical Hospital, LLC (Charleston Surgical Hospital)
• Charleston Surgical Hospital, LLC (CAMC Charleston Surgical Hospital)
• Charleston Treatment Center, LLC
• Charleston Treatment Center, LLC
• Aaliyah Chase
• Chloe Chasse
• Madhu Chaturyedi
• Allen Russell Chauvenet, MD
• Kerine Chavez

• Mental Health Clinic/Center (Including Community Mental Health Center) in Charleston, WV
• Providers in Charleston, WV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) 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.