Organization
OPEN SKYES FAMILY CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARYSSIA PHILLIP (OWNER)
(954) 864-0802
Entity
Organization
Contact information
Practice address
5600 SW 36TH ST, WEST PARK, FL 33023-6106
(954) 329-9796
Mailing address
8570 STIRLING RD STE 102, HOLLYWOOD, FL 33024-8204
(954) 329-9796
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
11/08/2020
Last updated
11/08/2020
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