Provider Demographics
NPI:1396553152
Name:BLUE SKIES TREATMENT CENTER LLC
Entity type:Organization
Organization Name:BLUE SKIES TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-925-4862
Mailing Address - Street 1:PO BOX 9047
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90608-9047
Mailing Address - Country:US
Mailing Address - Phone:213-925-4862
Mailing Address - Fax:
Practice Address - Street 1:8227 LINDANTE DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-1011
Practice Address - Country:US
Practice Address - Phone:562-665-4571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder