Healthcare Provider Details

I. General information

NPI: 1013703636
Provider Name (Legal Business Name): BLUE SKY SENIOR CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2472 PATTERSON RD UNIT 5
GRAND JUNCTION CO
81505-1100
US

IV. Provider business mailing address

2472 PATTERSON RD UNIT 5
GRAND JUNCTION CO
81505-1100
US

V. Phone/Fax

Practice location:
  • Phone: 970-212-7004
  • Fax:
Mailing address:
  • Phone: 970-212-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: BRANDI JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 970-212-7004