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General NPI Number Information
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NPI Number | 1245647387
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Entity Type | Organization
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Legal Business Name | BLUE SKIES HOME MANAGMENT SERVICES
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 7581 E 26TH ST
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City | YUMA
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State | AZ
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Zip | 85365-8615
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Country | US
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Telephone | 928-261-3673
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Fax | 928-726-5014
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Provider Business Mailing Address
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Address Line | 7581 E 26TH ST
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City | YUMA
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State | AZ
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Zip | 85365-8615
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Country | US
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Telephone | 928-261-3673
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Fax | 928-726-5014
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Authorized Official
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Title or Position | O
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Name | MS. LUCY OWNER ADAIR
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Credential | OWNER
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Telephone | 928-246-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 004053052014
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License Number State | AZ
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