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General NPI Number Information
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NPI Number | 1588230353
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Entity Type | Organization
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Legal Business Name | SKYLINE RECOVERY
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 623 BROOKLINE BLVD.
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City | PITTSBURGH
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State | PA
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Zip | 15226
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Country | US
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Telephone | 412-200-0765
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 59300
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City | PITTSBURGH
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State | PA
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Zip | 15210
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Country | US
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Telephone | 412-200-0765
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MYLES RYAN MAZZANTI
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Credential |
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Telephone | 412-200-0765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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