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General NPI Number Information
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NPI Number | 1497150254
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Entity Type | Organization
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Legal Business Name | STAR HOME CARE
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 350 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3073
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Country | US
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Telephone | 201-880-7089
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Fax | 201-880-7090
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Provider Business Mailing Address
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Address Line | 350 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3073
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Country | US
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Telephone | 201-880-7089
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Fax | 201-880-7090
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. DANIEL DESMOND HLAVATY
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Credential |
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Telephone | 201-880-7089
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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 | HP0194100
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License Number State | NJ
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