Open Skyes Family Care Home, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

OPEN SKYES FAMILY CARE HOME, LLC

Practice address

5600 SW 36TH St
West Park, FL 33023-6106

Phone

(954) 329-9796

NPI assigned

Nov 8, 2020

Organization subpart

No

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

Authorized official

Name

Aryssia Phillip

Title

Owner

Phone

(954) 864-0802

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604793600000",
    "number": "1518568294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8570 STIRLING RD STE 102",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248204",
            "telephone_number": "954-329-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 SW 36TH ST",
            "city": "WEST PARK",
            "state": "FL",
            "postal_code": "330236106",
            "telephone_number": "954-329-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN SKYES FAMILY CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-08",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-07",
        "status": "A",
        "authorized_official_last_name": "PHILLIP",
        "authorized_official_first_name": "ARYSSIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-864-0802"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aphillip@openskyes.hdirect.net",
            "affiliation": "N",
            "endpointDescription": "Secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure email",
            "address_1": "5600 SW 36th St",
            "city": "West Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330236106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.