Provider Demographics
NPI:1013616929
Name:BLUESKY REHABILITATION THERAPIES
Entity type:Organization
Organization Name:BLUESKY REHABILITATION THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:248-515-9903
Mailing Address - Street 1:1151 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-5977
Mailing Address - Country:US
Mailing Address - Phone:248-515-9903
Mailing Address - Fax:
Practice Address - Street 1:3058 N STATE RD STE E
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-3508
Practice Address - Country:US
Practice Address - Phone:810-652-6315
Practice Address - Fax:810-652-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty