MEDICARE: BLUESKY INTEGRATED HEALTHCARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1093676199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUESKY INTEGRATED HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1398 N SHADELAND AVE STE 2210
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-3618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1398 N SHADELAND AVE STE 2210
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-3618
Country	:	US
Telephone Number	:	317-970-1852
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	LUCKY ERENVEN
Credential	:
Telephone Number	:	317-970-1004

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	11/19/2025

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