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General NPI Number Information
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NPI Number | 1326685488
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Entity Type | Organization
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Legal Business Name | ALLSTAR MEDICAL RESPITE AND RECUPERATIVE CARE
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 450 N SPERRY DRIVE
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City | COLTON
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State | CA
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Zip | 92324
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Country | US
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Telephone | 909-945-9899
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Fax |
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Provider Business Mailing Address
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Address Line | 9521 BUSINESS CENTER DR STE 9-101
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7704
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Country | US
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Telephone | 909-904-7003
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Fax |
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Authorized Official
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Title or Position | CFO/ADMINISTRATOR DESIGNEE
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Name | MARIA CATHERINE KOH CHUA
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Credential |
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Telephone | 909-945-9899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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