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General NPI Number Information
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NPI Number | 1245835727
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Entity Type | Organization
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Legal Business Name | NEW STAR HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 8461 LAKE WORTH RD STE 1-254
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City | LAKE WORTH
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State | FL
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Zip | 33467-2474
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Country | US
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Telephone | 561-774-5985
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Fax | 561-248-9636
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Provider Business Mailing Address
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Address Line | 8461 LAKE WORTH RD STE 1-254
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City | LAKE WORTH
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State | FL
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Zip | 33467-2474
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Country | US
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Telephone | 561-774-5985
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Fax | 561-248-9636
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Authorized Official
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Title or Position | OWNER/PRESIDENT/ADMINISTRATOR
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Name | MARY YVENIE D GERTIN
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Credential |
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Telephone | 561-774-5985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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