Provider Demographics
NPI:1821502410
Name:MARIGOLD TREATMENT SERVICES
Entity Type:Organization
Organization Name:MARIGOLD TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-221-1091
Mailing Address - Street 1:316 STATION ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1830
Mailing Address - Country:US
Mailing Address - Phone:412-221-1091
Mailing Address - Fax:
Practice Address - Street 1:453 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2332
Practice Address - Country:US
Practice Address - Phone:412-221-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty