Provider Demographics
NPI:1831463165
Name:BLUESKY BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:BLUESKY BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-300-5055
Mailing Address - Street 1:52 FEDERAL RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6162
Mailing Address - Country:US
Mailing Address - Phone:203-300-5055
Mailing Address - Fax:203-942-2693
Practice Address - Street 1:52 FEDERAL RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6162
Practice Address - Country:US
Practice Address - Phone:203-300-5055
Practice Address - Fax:203-942-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0428261QM0850X
CT0516261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health