CORBIN'S CLUBHOUSE AUTISM & SPECIAL NEEDS CORPORATION


Address: 220 Milford St, Clarksburg, WV 26301-3517
Phone: 3046296706

CORBIN'S CLUBHOUSE AUTISM & SPECIAL NEEDS CORPORATION (NPI# 1457843336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457843336
Entity Type Organization
Organization Name CORBIN'S CLUBHOUSE AUTISM & SPECIAL NEEDS CORPORATION
Practice Address 220 Milford St
Clarksburg
WV 26301-3517
Mailing Address Po Box 1222
Clarksburg
WV 26302-1222
Practice Telephone 3046296706
Enumeration Date 2018-06-05
Last Update Date 2018-06-05
Authorized Official Name BILLEE JEAN BELL (CARE TAKER)
Authorized Official Telephone 3046296706
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 385HR2060X Respite Care
Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child
Respite Care Facility

Office Location

Street Address 220 MILFORD ST
City CLARKSBURG
State WV
Zip Code 26301-3517

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1114539525 Christina Burnside Technician 89 Green Acres, Clarksburg, WV 26301 2020-08-18
1447764907 Jonathan Moore Nurse Practitioner 1 Medical Ctr. Drive, Clarksburg, WV 26301 2017-11-20
1003241936 Jennifer Destito Occupational Therapist 308 E B Saunders Way, Clarksburg, WV 26301 2013-09-11
1215290481 Dustin James Getz Dentist 200 Route 98 Medwood Plaza, Suite 302, Nutter Fort, WV 26301 2012-06-21
1326339987 Debra Amos Counselor 200 Route 98, Nutter Fort, WV 26301 2011-04-29
1649572140 Amanda Wilfong Pharmacist W Pike and Smith St, Clarksburg, WV 26301 2010-12-03
1265661060 Jaclyn Elsey Rominger Dentist 2017 East Pike St, All Smiles Dental LLC, Clarksburg, WV 26301 2009-07-14
1588815732 Kimberly Sue Waggy Psychologist 408 Eb Saunders Way, Clarksburg, WV 26301 2008-10-07
1659521862 Eyemart Express, Ltd. Durable Medical Equipment & Medical Supplies 538 Emily Dr., Space 20, Clarksburg, WV 26301 2008-09-24
1477715753 Roxanna L Rinehart Registered Nurse 1 Med Ctr Dr, Louis A Johnson Vamc, Clarksburg, WV 26301 2008-06-27
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Taxonomy Information

Taxonomy Code 385HR2060X
Grouping Respite Care Facility
Classification Respite Care
Specialization Respite Care, Mental Retardation and/or Developmental Disabilities, Child

Taxonomy Definition

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers.
Notes: [7/1/2003: new]

Competitor

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City CLARKSBURG
Zip Code 26301

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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