| Big Sky Mind, Llc | |
|
15073 Shady Palms Ln Nokomis FL 34275-4340 | |
| (541) 668-6678 | |
| Not Available |
| Full Name | Big Sky Mind, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15073 Shady Palms Ln, Nokomis, Florida |
| Authorized Official Name and Position | Adam Klaybor (OWNER) |
| Authorized Official Contact | 5416686678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Sky Mind, Llc 15073 Shady Palms Ln Nokomis FL 34275-4340 Ph: (541) 668-6678 | Big Sky Mind, Llc 15073 Shady Palms Ln Nokomis FL 34275-4340 Ph: (541) 668-6678 |
| NPI Number | 1699446450 |
|---|---|
| Provider Enumeration Date | 09/22/2021 |
| Last Update Date | 04/22/2025 |
| Certification Date | 04/22/2025 |
| Medicare PECOS PAC ID | 3678970381 |
|---|---|
| Medicare Enrollment ID | O20210923000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699446450 | NPI | - | NPPES |
| 500794020 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Adam Michael Klaybor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750853453 PECOS PAC ID: 8820495534 Enrollment ID: I20210923000347 |
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