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General NPI Number Information
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NPI Number | 1396082004
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Entity Type | Organization
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Legal Business Name | STAR CENTER GROUP INC
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 5958 VINELAND AVE SUITE K
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-1329
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Country | US
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Telephone | 818-579-4342
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Fax | 818-821-6856
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Provider Business Mailing Address
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Address Line | 5958 VINELAND AVE SUITE K
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-1329
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Country | US
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Telephone | 818-821-6854
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Fax | 818-821-6856
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Authorized Official
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Title or Position | CEO
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Name | MARINE A. KESHISHIAN
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Credential | RN
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Telephone | 818-821-6854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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