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).
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 |
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 |
Street Address |
220 MILFORD ST |
City | CLARKSBURG |
State | WV |
Zip Code | 26301-3517 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
Find all providers in zip 26301 |
Taxonomy Code | 385HR2060X |
Grouping | Respite Care Facility |
Classification | Respite Care |
Specialization | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
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] |
City | CLARKSBURG |
Zip Code | 26301 |
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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.