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NPI Code Detail

MEDICARE: CLARKSBURG TREATMENT CENTER, LLC

MEDICARE: CLARKSBURG TREATMENT CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2800XMethadone Clinic03WV
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1013029156
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARKSBURG TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 6183 PASEO DEL NORTE, STE 200
Second Line :
City : CARLSBAD
State : CA
Zip : 92011-1155
Country : US
Telephone Number : 855-259-2288
Fax Number : 877-552-0439
Provider Business Practice Location Address
First Line : 706 OAKMOUND RD
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-9398
Country : US
Telephone Number : 304-622-7511
Fax Number : 304-622-6856
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN PHILLIP FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 08/31/2006
Last Update Date : 11/01/2024

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Directions to “CLARKSBURG TREATMENT CENTER, LLC ” Practice Location

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