Healthcare Provider Details

I. General information

NPI: 1487789392
Provider Name (Legal Business Name): SKILLS UNLIMITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 LOCUST AVE
OAKDALE NY
11769-1651
US

IV. Provider business mailing address

191 SWEET HOLLOW RD
OLD BETHPAGE NY
11804
US

V. Phone/Fax

Practice location:
  • Phone: 516-870-1600
  • Fax: 516-870-7060
Mailing address:
  • Phone: 516-870-1600
  • Fax: 516-870-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number6868003A
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number6868-110A
License Number StateNY

VIII. Authorized Official

Name: MR. ROBERT BUDD
Title or Position: CEO
Credential:
Phone: 516-870-1600