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General NPI Number Information
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NPI Number | 1255112207
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Entity Type | Organization
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Legal Business Name | BRIGHTSTAR SENIOR CARE, INC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 10455 GAYNOR AVE
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City | GRANADA HILLS
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State | CA
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Zip | 91344-7025
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Country | US
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Telephone | 818-517-0544
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Fax | 818-810-6913
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Provider Business Mailing Address
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Address Line | 10455 GAYNOR AVE
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City | GRANADA HILLS
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State | CA
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Zip | 91344-7025
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Country | US
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Telephone | 818-517-0544
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Fax | 818-810-6913
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Authorized Official
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Title or Position | PRESIDENT
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Name | AYEDEH ALLAHDADI
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Credential |
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Telephone | 818-517-0544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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