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General NPI Number Information
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NPI Number | 1114796042
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Entity Type | Organization
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Legal Business Name | BLUE SKY HOME CARE LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 21700 GREENFIELD RD STE 227
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City | OAK PARK
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State | MI
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Zip | 48237-2888
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Country | US
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Telephone | 248-808-6228
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Fax | 248-808-6228
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Provider Business Mailing Address
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Address Line | 21700 GREENFIELD RD STE 227
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City | OAK PARK
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State | MI
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Zip | 48237-2888
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Country | US
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Telephone | 248-808-6228
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Fax | 248-808-6228
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Authorized Official
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Title or Position | CEO
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Name | RENEE D TAYLOR
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Credential |
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Telephone | 313-806-5068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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