Sky Residential Services, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

DSL293 Issued in WI

Legal business name

SKY RESIDENTIAL SERVICES, INC

Practice address

2405 S Brookside Pkwy
New Berlin, WI 53151-2905

Phone

(414) 916-2710

NPI assigned

Oct 28, 2008

Organization subpart

No

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

Authorized official

Name

Kim Nguyen

Title

Cfo/Secretary

Phone

(414) 916-2710

Specialties & licenses 1

Addresses

Other names 1

• brookside, inc Former legal business name

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1821241464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N94W20846 SCHLEI RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530511127",
            "telephone_number": "414-916-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 S BROOKSIDE PKWY",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531512905",
            "telephone_number": "414-916-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY RESIDENTIAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CFO/SECRETARY",
        "authorized_official_telephone_number": "414-916-2710"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": "DSL293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "brookside, inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.