Provider Demographics
NPI:1497485262
Name:BLUE SKY MENTAL HEALTH CORP
Entity Type:Organization
Organization Name:BLUE SKY MENTAL HEALTH CORP
Other - Org Name:BLUE SKY MENTAL HEALTH CORP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-690-1884
Mailing Address - Street 1:2100 W 76TH ST STE 406
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5504
Mailing Address - Country:US
Mailing Address - Phone:305-530-8120
Mailing Address - Fax:786-933-9801
Practice Address - Street 1:2100 W 76TH ST STE 406
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5504
Practice Address - Country:US
Practice Address - Phone:305-530-8120
Practice Address - Fax:786-933-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management