Provider Demographics
NPI:1033775879
Name:SKYBLU RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:SKYBLU RESIDENTIAL SERVICES
Other - Org Name:ASTRAL HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MUNA
Authorized Official - Last Name:DOMBRET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:736-283-9973
Mailing Address - Street 1:8943 DUNBAR KNL N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-4013
Mailing Address - Country:US
Mailing Address - Phone:763-283-9973
Mailing Address - Fax:763-284-1050
Practice Address - Street 1:8943 DUNBAR KNL N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-4013
Practice Address - Country:US
Practice Address - Phone:763-283-9973
Practice Address - Fax:763-284-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care