Healthcare Provider Details

I. General information

NPI: 1447032586
Provider Name (Legal Business Name): SKYVIEW HEALTHCARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6739 WINDSOR MILL RD
GWYNN OAK MD
21207-4333
US

IV. Provider business mailing address

6739 WINDSOR MILL RD
GWYNN OAK MD
21207-4333
US

V. Phone/Fax

Practice location:
  • Phone: 443-985-7140
  • Fax:
Mailing address:
  • Phone: 443-985-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. VINCENT ANENE ANI
Title or Position: CEO
Credential: LMSW
Phone: 443-985-7140