Provider Demographics
NPI:1043732423
Name:SKYLIGHT SUPPORT GROUP
Entity type:Organization
Organization Name:SKYLIGHT SUPPORT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-325-0098
Mailing Address - Street 1:873 HAMILTON ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3140
Mailing Address - Country:US
Mailing Address - Phone:732-325-0098
Mailing Address - Fax:732-325-0098
Practice Address - Street 1:873 HAMILTON ST UNIT A
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3140
Practice Address - Country:US
Practice Address - Phone:732-325-0098
Practice Address - Fax:732-325-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty