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General NPI Number Information
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NPI Number | 1790980308
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Entity Type | Organization
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Legal Business Name | BLUESKY CHARTER SCHOOL
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 33 WENTWORTH AVE E STE 300
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City | SAINT PAUL
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State | MN
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Zip | 55118-3405
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Country | US
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Telephone | 651-642-0888
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Fax | 651-642-0435
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Provider Business Mailing Address
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Address Line | 33 WENTWORTH AVE E STE 300
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City | SAINT PAUL
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State | MN
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Zip | 55118-3405
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Country | US
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Telephone | 651-642-0888
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Fax | 651-642-0435
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Authorized Official
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Title or Position | DIRECTOR OF STUDENT SERVICES
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Name | MR. CHRISTIAN KERNO
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Credential | LICSW
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Telephone | 651-642-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | MNLICSW3168
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License Number State | MN
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