Provider Demographics
NPI:1427560143
Name:SKYCARE INC
Entity Type:Organization
Organization Name:SKYCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAHHAR
Authorized Official - Middle Name:IBN
Authorized Official - Last Name:WALI
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:609-417-7834
Mailing Address - Street 1:1306 CAMELOT CT
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-1572
Mailing Address - Country:US
Mailing Address - Phone:609-417-7834
Mailing Address - Fax:
Practice Address - Street 1:412 CHAMBERS AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1405
Practice Address - Country:US
Practice Address - Phone:609-417-7834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities