Provider Demographics
NPI:1255169652
Name:SKYE HOMECARE LLC
Entity type:Organization
Organization Name:SKYE HOMECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PAYNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-961-7997
Mailing Address - Street 1:11550 W IH 10 STE 340
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1061
Mailing Address - Country:US
Mailing Address - Phone:925-961-7997
Mailing Address - Fax:
Practice Address - Street 1:25500 TWO CREEKS APT 1316
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-2502
Practice Address - Country:US
Practice Address - Phone:925-961-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health