MEDICARE: MORNING STAR ADULT FAMILY CARE HOME, INC.

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1104602564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORNING STAR ADULT FAMILY CARE HOME, INC.

Provider Business Mailing Address
First Line	:	PO BOX 33027
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33420-3027
Country	:	US
Telephone Number	:	561-719-2926
Fax Number	:	888-241-9661

Provider Business Practice Location Address
First Line	:	3387 RCA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3221
Country	:	US
Telephone Number	:	561-719-2926
Fax Number	:	888-241-9661

Authorized Official
Title or Position	:	OWNER
Name	:	JULIETA CASTIBLANCO
Credential	:
Telephone Number	:	561-719-2926

Provider Enumeration Date	:	09/01/2023
Last Update Date	:	10/06/2023

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