| Clarksburg Treatment Center, Llc | |
|
706 Oakmound Rd Clarksburg WV 26301-9398 | |
| (304) 622-7511 | |
| (304) 622-6856 |
| Full Name | Clarksburg Treatment Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 706 Oakmound Rd, Clarksburg, West Virginia |
| Authorized Official Name and Position | Brian Phillip Farley (VP & SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksburg Treatment Center, Llc 6183 Paseo Del Norte, Ste 200 Carlsbad CA 92011-1155 Ph: (855) 259-2288 | Clarksburg Treatment Center, Llc 706 Oakmound Rd Clarksburg WV 26301-9398 Ph: (304) 622-7511 |
| NPI Number | 1013029156 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/11/2023 |
| Certification Date | 08/11/2023 |
| Medicare PECOS PAC ID | 9931534245 |
|---|---|
| Medicare Enrollment ID | O20230412000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013029156 | NPI | - | NPPES |
| Provider Name | Edward P Brennan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316117815 PECOS PAC ID: 0547326001 Enrollment ID: I20090306000593 |
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