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General NPI Number Information
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NPI Number | 1043102353
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Entity Type | Organization
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Legal Business Name | SKYEVIDA HOME CARE, LLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 3960 SOUTHEASTERN AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-1500
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Country | US
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Telephone | 317-683-7068
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Fax |
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Provider Business Mailing Address
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Address Line | 8520 ALLISON POINTE BLVD STE 220
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-4299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | JERREL ROGERS
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Credential |
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Telephone | 317-753-6166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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