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General NPI Number Information
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NPI Number | 1437469228
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Entity Type | Organization
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Legal Business Name | BLUE SKY ABILTIIES, LLC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 1301 W BEN WHITE BLVD 200H
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City | AUSTIN
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State | TX
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Zip | 78704-7623
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Country | US
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Telephone | 512-924-1111
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Fax | 512-532-6902
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Provider Business Mailing Address
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Address Line | PO BOX 151173
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City | AUSTIN
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State | TX
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Zip | 78715-1173
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Country | US
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Telephone | 512-924-1111
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Fax | 512-532-6902
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DONNA SUE MILLER
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Credential | M.A., C.T.R.S.
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Telephone | 512-924-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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