Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Adolescent and Children Mental Health |
261QM0855X | |||
Adult Mental Health |
261QM0850X | |||
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI Number | 1720560832 |
| LBN Legal business name | BLUE SKIES PSYCHOLOGICAL SERVICES, LLC |
| Authorized official | SEAN DODGE - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/05/2018 |
| Last updated | 09/05/2018 - About 8 years ago |
| Identifiers | n/a |
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