BLUE SKY BEHAVIORAL SERVICES, INC (NPI# 1376175737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376175737 |
| Entity Type | Organization |
| Organization Name | BLUE SKY BEHAVIORAL SERVICES, INC |
| Practice Address |
291 Awin Cir Se Palm Bay FL 32909-8563 |
| Practice Telephone | 3213396156 |
| Mailing Telephone | 3213396156 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |
| Authorized Official Name | LUCIA P GRANCHAMPS (MANAGER) |
| Authorized Official Telephone | 3213396156 |
| Authorized Official Credential | BAS |
| Is Organization Subpart | Y |
| Parent Organization Name | BLUE SKY BEHAVIORAL SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| BLUE S. B. SERVICES | Doing Business As Name - Organization |
| Street Address |
291 AWIN CIR SE |
| City | PALM BAY |
| State | FL |
| Zip Code | 32909-8563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447349 | Sarah Nicosia | Registered Nurse | 2752 Palisades Dr, Palm Bay, FL 32909 | 2020-08-12 |
| 1447881297 | Shangri-la of Palm Bay Alf, LLC | Assisted Living Facility | 3604 Jupiter Blvd. Se, Palm Bay, FL 32909 | 2020-01-30 |
| 1972094357 | Mindful Counseling and Wellness LLC | Social Worker | 221 Devlin Ct Se, Palm Bay, FL 32909 | 2018-05-22 |
| 1306348859 | Mallory Kathleen Herndon | Behavior Technician | 458 Barcelona Rd, Palm Bay, FL 32909 | 2018-03-01 |
| 1548786627 | Chotsani Merrill | Home Health Aide | 781 Davenport St Se, Palm Bay, FL 32909 | 2017-08-21 |
| 1639629538 | Maggie Cameron | Clinic/Center | 2511 Quentin Ave Ne, Palm Bay, FL 32909 | 2016-10-04 |
| 1194195016 | Dawn Goodwin | Pharmacist | 3450 Bayside Lakes Shopping Center, Palm Bay, FL 32909 | 2015-10-05 |
| 1124407796 | Jorge Ortiz | Physical Therapist | 470 Malabar Rd Se, Ste 102, Palm Bay, FL 32909 | 2015-05-28 |
| 1932506227 | Annalisa Tietjen I | Dental Hygienist | 714 Ave C, Fort Pierce, FL 32909 | 2014-12-02 |
| 1194147611 | Carl Glenmore Morrison Sr. | General Practice | 2125 Windbrook Drive, Palm Bay, FL 32909 | 2014-01-17 |
| Find all providers in zip 32909 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1215407234 | Palm Quality Care Inc | Clinic/Center | 976 Lyons Cir Nw, Palm Bay, FL 32907-5920 | 2018-12-03 |
| 1295202190 | Timika Marie Washington | Clinic/Center | 457 Abello Rd Se, Palm Bay, FL 32909-8806 | 2018-10-29 |
| 1477059541 | Helping Heartz From Above LLC | Clinic/Center | 1344 Mit Ct Nw, Palm Bay, FL 32907-7853 | 2018-04-05 |
| 1417483470 | Cleo Wyllie | Clinic/Center | 163 Haines Rd Sw, Palm Bay, FL 32908-1338 | 2017-05-11 |
| 1699201624 | Khadiyah Joseph | Clinic/Center | 1376 Walthan St Se, Palm Bay, FL 32909-6053 | 2017-05-11 |
| 1639629538 | Maggie Cameron | Clinic/Center | 2511 Quentin Ave Ne, Palm Bay, FL 32909 | 2016-10-04 |
| 1518463785 | Tiffanie Williams | Clinic/Center | 1344 Mit Ct Nw, Palm Bay, FL 32907 | 2018-04-05 |
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| 1619578192 | Elsyoff Care Center LLC | Clinic/Center | 1727 Nw 19th Ter, Cape Coral, FL 33993-4915 | 2020-11-02 |
| 1417558099 | Trnity Fields Inc | Clinic/Center | 12210 Netherfield Ct, Riverview, FL 33569-4117 | 2020-11-02 |
| 1891395430 | Kettia Noel | Clinic/Center | 1573 Se Clearbrook St, Port Saint Lucie, FL 34983-4050 | 2020-10-30 |
| 1740880871 | Salubrious Home Therapy Services, Inc | Clinic/Center | 3421 Sw 114th Ct, Miami, FL 33165-3330 | 2020-10-28 |
| 1407456718 | Evelyne Charles | Clinic/Center | 3301 White Blossom Ln, Clermont, FL 34711-6366 | 2020-10-27 |
| 1295334191 | Aging At Home LLC | Clinic/Center | 1858 Forest Hills Rd, Jacksonville, FL 32208-2535 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.