Organization
BLUESKY PRIME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED ODOWAA (OWNER)
(612) 986-5653
Entity
Organization
Contact information
Practice address
6819 PARK RIDGE DR, MADISON, WI 53719-2221
(763) 300-2242
Mailing address
6819 PARK RIDGE DR, MADISON, WI 53719-2221
(763) 300-2242
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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