Healthcare Provider Details

I. General information

NPI: 1396553152
Provider Name (Legal Business Name): BLUE SKIES TREATMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8227 LINDANTE DR
WHITTIER CA
90603-1011
US

IV. Provider business mailing address

PO BOX 9047
WHITTIER CA
90608-9047
US

V. Phone/Fax

Practice location:
  • Phone: 562-665-4571
  • Fax:
Mailing address:
  • Phone: 213-925-4862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN BARRERA
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 213-925-4862