Provider Demographics
NPI:1275937534
Name:BLUE SKY CASE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:BLUE SKY CASE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:520-360-3900
Mailing Address - Street 1:291 N HUBBARDS LN
Mailing Address - Street 2:SUITE 172-167
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-2295
Mailing Address - Country:US
Mailing Address - Phone:502-354-3348
Mailing Address - Fax:502-805-0530
Practice Address - Street 1:4050 WESTPORT RD
Practice Address - Street 2:SUITE 213
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3102
Practice Address - Country:US
Practice Address - Phone:502-354-3348
Practice Address - Fax:502-805-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0880571251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management