Provider Demographics
NPI:1649978297
Name:BLUE SKY BEHAVIORAL CARE LLC
Entity type:Organization
Organization Name:BLUE SKY BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SKYLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-977-5098
Mailing Address - Street 1:7719 PERREGRINE PL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-5955
Mailing Address - Country:US
Mailing Address - Phone:425-977-5098
Mailing Address - Fax:
Practice Address - Street 1:7719 PERREGRINE PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-5955
Practice Address - Country:US
Practice Address - Phone:425-977-5098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty