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General NPI Number Information
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NPI Number | 1831463165
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Entity Type | Organization
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Legal Business Name | BLUESKY BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 52 FEDERAL RD SUITE 2A
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City | DANBURY
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State | CT
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Zip | 06810-6162
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Country | US
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Telephone | 203-300-5055
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Fax | 203-942-2693
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Provider Business Mailing Address
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Address Line | 52 FEDERAL RD SUITE 2A
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City | DANBURY
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State | CT
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Zip | 06810-6162
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Country | US
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Telephone | 203-300-5055
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Fax | 203-942-2693
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MRS. BETSY BERGMAN
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Credential |
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Telephone | 203-300-5055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0428
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0516
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License Number State | CT
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