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General NPI Number Information
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NPI Number | 1316484363
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Entity Type | Organization
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Legal Business Name | STAR ONE HEALTHCARE.LLC
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 2443 CHERRY RD STE B
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City | ROCK HILL
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State | SC
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Zip | 29732-2172
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Country | US
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Telephone | 866-978-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 CHERRY RD, SUITE B
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City | ROCK HILL
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State | SC
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Zip | 29732
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Country | US
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Telephone | 866-978-2444
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF MARKETING
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Name | MS. KADIA MCCANN
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Credential | BA, PSYCHOLOGY
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Telephone | 866-978-2444
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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 | IHCP-0653
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License Number State | SC
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