MEDICARE: STAR HOME CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1003149410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR HOME CARE, LLC

Provider Business Mailing Address
First Line	:	24225 W 9 MILE RD
Second Line	:	STE 206
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3962
Country	:	US
Telephone Number	:	248-787-1703
Fax Number	:	248-223-4431

Provider Business Practice Location Address
First Line	:	24225 W 9 MILE RD
Second Line	:	STE 206
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3962
Country	:	US
Telephone Number	:	248-787-1703
Fax Number	:	248-223-4431

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. NAEEM B SHAKOOR
Credential	:
Telephone Number	:	248-787-1703

Provider Enumeration Date	:	09/16/2009
Last Update Date	:	09/16/2009

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