Provider Demographics
NPI:1215589197
Name:CARDINAL TREATMENT CENTERS INC
Entity Type:Organization
Organization Name:CARDINAL TREATMENT CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKLYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-343-2772
Mailing Address - Street 1:4304 OLD SCIOTO TRL
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6672
Mailing Address - Country:US
Mailing Address - Phone:740-821-1737
Mailing Address - Fax:740-934-6011
Practice Address - Street 1:4312 OLD SCIOTO TRL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6642
Practice Address - Country:US
Practice Address - Phone:740-351-9298
Practice Address - Fax:740-934-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder