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General NPI Number Information
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NPI Number | 1639528029
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Entity Type | Organization
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Legal Business Name | STARLIGHT HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 954 MOUNT GALLANT RD A
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City | ROCK HILL
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State | SC
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Zip | 29730-2873
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Country | US
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Telephone | 704-451-5531
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Fax | 866-523-4376
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Provider Business Mailing Address
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Address Line | 954 MOUNT GALLANT RD A
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City | ROCK HILL
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State | SC
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Zip | 29730-2873
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Country | US
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Telephone | 704-451-5531
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Fax | 866-523-4376
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANIEMA UDOH
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Credential |
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Telephone | 704-451-5531
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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-0362
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License Number State | SC
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