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General NPI Number Information
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NPI Number | 1740618396
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Entity Type | Organization
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Legal Business Name | STAR QUALITY NURSING AGENCY
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Dates
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Enumeration Date | 10/17/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 99 NW 183RD ST SUITE 230
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City | MIAMI
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State | FL
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Zip | 33169-4502
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Country | US
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Telephone | 305-454-9070
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Fax | 305-705-3256
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Provider Business Mailing Address
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Address Line | 99 NW 183RD ST SUITE 230
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City | MIAMI
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State | FL
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Zip | 33169-4502
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Country | US
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Telephone | 305-454-9070
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Fax | 305-705-3256
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Authorized Official
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Title or Position | CEO
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Name | ELIZABETH ALICE DAVIS
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Credential |
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Telephone | 305-454-9070
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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 | 30211665
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License Number State | FL
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