Healthcare Provider Details

I. General information

NPI: 1366097834
Provider Name (Legal Business Name): BLUE SKY ADULT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 08/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 S STATE ROAD 7
NORTH LAUDERDALE FL
33068-4023
US

IV. Provider business mailing address

16452 SW 28TH CT
MIRAMAR FL
33027-5215
US

V. Phone/Fax

Practice location:
  • Phone: 954-736-7227
  • Fax:
Mailing address:
  • Phone: 754-423-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY RAMLOCHAN
Title or Position: CEO
Credential: RN
Phone: 754-423-4691