Provider Demographics
NPI:1093200214
Name:SKY POINT SOCIAL SERVICES
Entity Type:Organization
Organization Name:SKY POINT SOCIAL SERVICES
Other - Org Name:SKY POINT SOCIAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOMO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:260-492-9334
Mailing Address - Street 1:5800 FAIRFIELD AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46807-3416
Mailing Address - Country:US
Mailing Address - Phone:260-492-9334
Mailing Address - Fax:
Practice Address - Street 1:5800 FAIRFIELD AVENUE
Practice Address - Street 2:STE 265
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46807
Practice Address - Country:US
Practice Address - Phone:260-492-9334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201404140AMedicaid