| Sky Point Social Services | |
|
5800 Fairfield Avenue Ste 265 Fort Wayne IN 46807 | |
| (260) 492-9334 | |
| Not Available |
| Full Name | Sky Point Social Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5800 Fairfield Avenue, Fort Wayne, Indiana |
| Authorized Official Name and Position | Francis Jomo (OWNER) |
| Authorized Official Contact | 2604929334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sky Point Social Services 5800 Fairfield Ave Ste 265 Fort Wayne IN 46807-3416 Ph: (260) 492-9334 | Sky Point Social Services 5800 Fairfield Avenue Ste 265 Fort Wayne IN 46807 Ph: (260) 492-9334 |
| NPI Number | 1093200214 |
|---|---|
| Provider Enumeration Date | 06/29/2018 |
| Last Update Date | 05/20/2022 |
| Certification Date | 05/20/2022 |
| Medicare PECOS PAC ID | 1254718612 |
|---|---|
| Medicare Enrollment ID | O20220524003019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093200214 | NPI | - | NPPES |
| 201404140A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Klinton Richard Krouse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558698357 PECOS PAC ID: 3375774706 Enrollment ID: I20140327000711 |
| Provider Name | Crystal Havins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396106068 PECOS PAC ID: 2062899420 Enrollment ID: I20220524003081 |
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