Organization
BLUE SKY GROUP HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MEDARDO GOMEZ (PRESIDENT, OWNER)
(786) 316-3419
Entity
Organization
Contact information
Practice address
11000 SW 142ND PL, MIAMI, FL 33186-7011
(786) 316-3419
(305) 595-3679
Mailing address
11000 SW 142ND PL, MIAMI, FL 33186-7011
(786) 316-3419
(305) 595-3679
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10892
FL
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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