Healthcare Provider Details

I. General information

NPI: 1407968779
Provider Name (Legal Business Name): CARE STAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 HARDING RD
MARION OH
43302-5431
US

IV. Provider business mailing address

682 HARDING RD
MARION OH
43302-5431
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-5897
  • Fax:
Mailing address:
  • Phone: 740-383-5897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number247-5138
License Number StateOH

VIII. Authorized Official

Name: LINDA MEISTER
Title or Position: INDEPENDENT LIVING SERVICES PROVIDE
Credential:
Phone: 740-387-1780