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General NPI Number Information
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NPI Number | 1700807476
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Entity Type | Organization
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Legal Business Name | WHITE STAR HEALTH SYSTEMS, INC.
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 4100 LATHAM ST STE H
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City | RIVERSIDE
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State | CA
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Zip | 92501-1733
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Country | US
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Telephone | 951-684-4589
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Fax | 951-684-6051
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Provider Business Mailing Address
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Address Line | 4100 LATHAM ST STE H
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City | RIVERSIDE
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State | CA
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Zip | 92501-1733
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Country | US
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Telephone | 951-684-4589
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Fax | 951-684-6051
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. PATRICK ROJAS AFAN
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Credential |
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Telephone | 951-684-4589
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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 | CA
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