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General NPI Number Information
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NPI Number | 1679931901
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Entity Type | Organization
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Legal Business Name | BLUE STAR HOMEHEALTH AGENCY, INC
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 1140 EMPIRE CENTRAL DR STE 630
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City | DALLAS
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State | TX
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Zip | 75247-4393
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Country | US
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Telephone | 972-408-6409
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Fax | 214-253-2655
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Provider Business Mailing Address
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Address Line | 1633 HAWKINS CT
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City | CARROLLTON
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State | TX
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Zip | 75010-3252
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Country | US
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Telephone | 469-892-4241
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Fax | 469-892-4150
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ALERO T OKUNDIA
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Credential | RN
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Telephone | 469-892-4241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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