Healthcare Provider Details

I. General information

NPI: 1063462109
Provider Name (Legal Business Name): PICKAWAY AREA RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 09/02/2025
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HIGHLAND AVE
CIRCLEVILLE OH
43113-1208
US

IV. Provider business mailing address

110 HIGHLAND AVE
CIRCLEVILLE OH
43113-1208
US

V. Phone/Fax

Practice location:
  • Phone: 740-477-1745
  • Fax: 740-477-2779
Mailing address:
  • Phone: 740-477-1745
  • Fax: 740-477-2779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: AARON SHIPE
Title or Position: CFO
Credential:
Phone: 740-477-1745