NPI 1366233801

Bluesky Prime Care LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Madison, WI

Practice location

Address: 6819 Park Ridge Dr, Madison, WI 53719-2221
Phone: (763) 300-2242

Authorised official

Name: Mohamed Odowaa
Title: Owner
Phone: (612) 986-5653

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1366233801
Entity type: Organization
NPI issued: 14 May 2025
Record last updated: 14 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.