Healthcare Provider Details

I. General information

NPI: 1245835727
Provider Name (Legal Business Name): NEW STAR HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8461 LAKE WORTH RD STE 1-254
LAKE WORTH FL
33467-2474
US

IV. Provider business mailing address

8461 LAKE WORTH RD STE 1-254
LAKE WORTH FL
33467-2474
US

V. Phone/Fax

Practice location:
  • Phone: 561-774-5985
  • Fax: 561-248-9636
Mailing address:
  • Phone: 561-774-5985
  • Fax: 561-248-9636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY YVENIE D GERTIN
Title or Position: OWNER/PRESIDENT/ADMINISTRATOR
Credential:
Phone: 561-774-5985