Provider Demographics
NPI:1205647195
Name:SKYLAR'S HEALER
Entity type:Organization
Organization Name:SKYLAR'S HEALER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KWAME
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPELL-ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-469-3018
Mailing Address - Street 1:4439 FISCHER ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-1267
Mailing Address - Country:US
Mailing Address - Phone:313-469-3018
Mailing Address - Fax:
Practice Address - Street 1:4439 FISCHER ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-1267
Practice Address - Country:US
Practice Address - Phone:313-469-3018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty