Provider Demographics
NPI:1073282083
Name:SKY SUITE THERAPY SERVICES
Entity Type:Organization
Organization Name:SKY SUITE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:IRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:832-588-3280
Mailing Address - Street 1:4919 ORCHARD GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-3437
Mailing Address - Country:US
Mailing Address - Phone:832-588-3280
Mailing Address - Fax:
Practice Address - Street 1:15211 PARK ROW
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084
Practice Address - Country:US
Practice Address - Phone:832-588-3280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty