Provider Demographics
NPI:1942986229
Name:BLUE SKY THERAPY INC.
Entity Type:Organization
Organization Name:BLUE SKY THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:ELVIN
Authorized Official - Last Name:POLLY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:800-308-7591
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:WAUNETA
Mailing Address - State:NE
Mailing Address - Zip Code:69045-0366
Mailing Address - Country:US
Mailing Address - Phone:800-308-7591
Mailing Address - Fax:
Practice Address - Street 1:73452 AVENUE 347
Practice Address - Street 2:
Practice Address - City:WAUNETA
Practice Address - State:NE
Practice Address - Zip Code:69045-7149
Practice Address - Country:US
Practice Address - Phone:800-308-7591
Practice Address - Fax:888-375-5929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty