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General NPI Number Information
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NPI Number | 1649970690
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Entity Type | Organization
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Legal Business Name | SKYBOX LIVING LLC
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 32406 FRANKLIN RD # 16
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City | FRANKLIN
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State | MI
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Zip | 48025-7029
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Country | US
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Telephone | 248-217-5871
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 250016
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City | FRANKLIN
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State | MI
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Zip | 48025-0016
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Country | US
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Telephone | 248-217-5871
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER
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Name | SONYA JUAN WILSON
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Credential | SOCIAL WORKER
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Telephone | 248-217-5871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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