1619130226 NPI number — 5 STAR HOME CARE, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619130226 NPI number — 5 STAR HOME CARE, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
5 STAR HOME CARE, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619130226
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 N FEDERAL HWY
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
HALLANDALE BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33009-2400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-391-7676
Provider Business Mailing Address Fax Number:
954-391-7788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 N FEDERAL HWY
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
HALLANDALE BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33009-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-391-7676
Provider Business Practice Location Address Fax Number:
954-391-7788
Provider Enumeration Date:
07/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MORCATE
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
305-854-1066

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA299993186 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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