Healthcare Provider Details

I. General information

NPI: 1730899360
Provider Name (Legal Business Name): CARDINAL TREATMENT CENTERS PIKETON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 WESTERN AVE
CHILLICOTHEE OH
45602-2343
US

IV. Provider business mailing address

4304 OLD SCIOTO TRL
PORTSMOUTH OH
45662-6672
US

V. Phone/Fax

Practice location:
  • Phone: 740-351-9298
  • Fax: 740-529-0553
Mailing address:
  • Phone: 740-351-9298
  • Fax: 740-529-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BEATRICE SHKLYAR
Title or Position: OFFICER
Credential:
Phone: 201-787-8481