Provider Demographics
NPI:1144676768
Name:SKYCARE SERVICES LLC
Entity type:Organization
Organization Name:SKYCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUIANA
Authorized Official - Middle Name:MESHELL
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-999-2099
Mailing Address - Street 1:6047 TYVOLA GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-6431
Mailing Address - Country:US
Mailing Address - Phone:980-999-2099
Mailing Address - Fax:980-999-2094
Practice Address - Street 1:6047 TYVOLA GLEN CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-6431
Practice Address - Country:US
Practice Address - Phone:980-999-2099
Practice Address - Fax:980-999-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty