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General NPI Number Information
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NPI Number | 1720448988
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Entity Type | Organization
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Legal Business Name | STELLAR CARE SERVICES LLC
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 1243 S RUBY ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-4807
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Country | US
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Telephone | 919-824-0454
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Fax |
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Provider Business Mailing Address
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Address Line | 1243 S RUBY ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-4807
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Country | US
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Telephone | 919-824-0454
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. RAYMOND DAVIES III
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Credential | M.ED, M.S.
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Telephone | 215-678-0787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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