| Centerville Clinics Inc | |
|
Beth Center Elementary School 194 Crawford Road Fredericktown PA 15333 | |
| (724) 267-4944 | |
| (724) 267-4905 |
| Full Name | Centerville Clinics Inc |
|---|---|
| Speciality | Social Worker |
| Location | Beth Center Elementary School, Fredericktown, Pennsylvania |
| Authorized Official Name and Position | Barry Niccolai (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7246326801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerville Clinics Inc Centerville Clinics Inc 1070 Old National Pike Road Fredericktown PA 15333-2114 Ph: (724) 632-6801 | Centerville Clinics Inc Beth Center Elementary School 194 Crawford Road Fredericktown PA 15333 Ph: (724) 267-4944 |
| NPI Number | 1871079962 |
|---|---|
| Provider Enumeration Date | 07/12/2018 |
| Last Update Date | 07/12/2018 |
| Medicare PECOS PAC ID | 7214837202 |
|---|---|
| Medicare Enrollment ID | O20210525001712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871079962 | NPI | - | NPPES |
| 1007288440027 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041S0200X | Social Worker - School | (Pennsylvania) | Primary |
Centerville Clinics Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1070 Old National Pike, Fredericktown, PA 15333 Phone: 724-632-6801 Fax: 724-632-6312 | |
Centerville Clinics , Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1070 Old National Pike, Fredericktown, PA 15333 Phone: 724-632-6801 Fax: 724-632-6312 | |
Centerville Clinics Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Beth Center Middle School, 136 Crawford Road, Fredericktown, PA 15333 Phone: 724-267-4935 Fax: 724-267-4937 |