Healthcare Provider Details

I. General information

NPI: 1992732531
Provider Name (Legal Business Name): STAR OF LIFE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 SPRINGFIELD AVE
LAREDO TX
78040
US

IV. Provider business mailing address

2919 SPRINGFIELD AVE
LAREDO TX
78040-2634
US

V. Phone/Fax

Practice location:
  • Phone: 956-568-0111
  • Fax: 956-753-0112
Mailing address:
  • Phone: 956-568-0111
  • Fax: 956-753-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010364
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number010364
License Number StateTX

VIII. Authorized Official

Name: MRS. CLAUDIA S HOURIGAN
Title or Position: DIRECTOR OF NURSING / ADMINISTRATOR
Credential: R.N.
Phone: 956-568-0111