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General NPI Number Information
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NPI Number | 1801600960
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Entity Type | Organization
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Legal Business Name | BLUE SKY ADHC, LLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 7700 IMPERIAL HWY, UNIT R
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City | DOWNEY
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State | CA
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Zip | 90242-3466
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Country | US
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Telephone | 562-999-9935
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Fax | 562-999-9934
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Provider Business Mailing Address
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Address Line | 6315 ETHEL AVE
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City | VAN NUYS
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State | CA
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Zip | 91401-2524
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Country | US
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Telephone | 562-999-9935
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Fax | 562-999-9934
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Authorized Official
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Title or Position | PRESIDENT
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Name | GAYANE KIRAKOSYAN
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Credential |
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Telephone | 562-999-9935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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