Provider Demographics
NPI:1124515085
Name:SKYDDACARE, LLC
Entity type:Organization
Organization Name:SKYDDACARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER AND CHAIR OF CLINICAL OP
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, BSN, RN, CCM
Authorized Official - Phone:732-786-4441
Mailing Address - Street 1:4400 ROUTE 9 S STE 1000
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1383
Mailing Address - Country:US
Mailing Address - Phone:732-409-5126
Mailing Address - Fax:
Practice Address - Street 1:4400 ROUTE 9 S STE 1000
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1383
Practice Address - Country:US
Practice Address - Phone:732-409-5126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health