Healthcare Provider Details

I. General information

NPI: 1568512770
Provider Name (Legal Business Name): REGION VIII, ONE SKY COMMUNITY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 BANFIELD RD STE 3
PORTSMOUTH NH
03801-5647
US

IV. Provider business mailing address

755 BANFIELD RD STE 3
PORTSMOUTH NH
03801-5647
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-6111
  • Fax: 603-436-4622
Mailing address:
  • Phone: 603-436-6111
  • Fax: 603-436-4622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MATT CORDARO
Title or Position: CEO
Credential:
Phone: 603-436-6111