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General NPI Number Information
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NPI Number | 1992732531
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Entity Type | Organization
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Legal Business Name | STAR OF LIFE HOME CARE INC
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 2919 SPRINGFIELD AVE
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City | LAREDO
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State | TX
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Zip | 78040
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Country | US
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Telephone | 956-568-0111
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Fax | 956-753-0112
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Provider Business Mailing Address
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Address Line | 2919 SPRINGFIELD AVE
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City | LAREDO
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State | TX
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Zip | 78040-2634
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Country | US
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Telephone | 956-568-0111
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Fax | 956-753-0112
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Authorized Official
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Title or Position | DIRECTOR OF NURSING / ADMINISTRATOR
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Name | MRS. CLAUDIA S HOURIGAN
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Credential | R.N.
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Telephone | 956-568-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 010364
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010364
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License Number State | TX
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