Provider Demographics
NPI:1992173397
Name:BLUES SKIES HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BLUES SKIES HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-246-8990
Mailing Address - Street 1:7581 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-8615
Mailing Address - Country:US
Mailing Address - Phone:928-261-3673
Mailing Address - Fax:928-726-5014
Practice Address - Street 1:7581 E 26TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8615
Practice Address - Country:US
Practice Address - Phone:928-261-3673
Practice Address - Fax:928-726-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008231062015302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization