Blue Sky Behavioral Services, Inc

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

BLUE SKY BEHAVIORAL SERVICES, INC

Doing business as

Blue S. B. Services

Practice address

291 Awin Cir SE
Palm Bay, FL 32909-8563

Phone

(321) 339-6156

NPI assigned

Feb 4, 2020

Last updated

Feb 4, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

BLUE SKY BEHAVIORAL SERVICES, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lucia P Granchamps, BAS

Title

Manager

Phone

(321) 339-6156

Specialties & licenses 1

Addresses

Other names 1

• BLUE S. B. SERVICES Doing business as

Part of

Blue Sky Behavioral Services Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1376175737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 AWIN CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098563",
            "telephone_number": "321-339-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 AWIN CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098563",
            "telephone_number": "321-339-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY BEHAVIORAL SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE SKY BEHAVIORAL SERVICES, INC.",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "GRANCHAMPS",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-339-6156",
        "authorized_official_credential": "BAS"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE S. B. SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmental Disabilities Clinic/Center in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.