Healthcare Provider Details

I. General information

NPI: 1437961588
Provider Name (Legal Business Name): FIVE STARS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 WISCONSIN AVE
BETHESDA MD
20814-3185
US

IV. Provider business mailing address

3900 JERMANTOWN RD STE 420
FAIRFAX VA
22030-4900
US

V. Phone/Fax

Practice location:
  • Phone: 408-455-0059
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD ATTARI
Title or Position: ADMINISTRATOR
Credential:
Phone: 408-455-0059