Provider Demographics
NPI:1285881011
Name:SKB THERAPY SERVICES INC
Entity type:Organization
Organization Name:SKB THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BLACKETER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:303-263-0394
Mailing Address - Street 1:10694 W 85TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-4714
Mailing Address - Country:US
Mailing Address - Phone:303-263-0394
Mailing Address - Fax:
Practice Address - Street 1:10694 W 85TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-4714
Practice Address - Country:US
Practice Address - Phone:303-263-0394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO914373261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO24888231Medicaid