Provider Demographics
NPI:1588230353
Name:SKYLINE RECOVERY
Entity Type:Organization
Organization Name:SKYLINE RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:MAZZANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-200-0765
Mailing Address - Street 1:P.O. BOX 59300
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210
Mailing Address - Country:US
Mailing Address - Phone:412-200-0765
Mailing Address - Fax:
Practice Address - Street 1:623 BROOKLINE BLVD.
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226
Practice Address - Country:US
Practice Address - Phone:412-200-0765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health