Provider Demographics
NPI:1124623939
Name:ULA SKY LLC
Entity type:Organization
Organization Name:ULA SKY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ULA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:517-921-8627
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:SOMERSET CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49282-0081
Mailing Address - Country:US
Mailing Address - Phone:517-921-8627
Mailing Address - Fax:
Practice Address - Street 1:11 E CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1619
Practice Address - Country:US
Practice Address - Phone:517-921-8627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty