MEDICARE: STELLAR FAMILY SERVICES, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1578077392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELLAR FAMILY SERVICES, INC.

Provider Business Mailing Address
First Line	:	5335 S VALENTIA WAY APT 251
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-3115
Country	:	US
Telephone Number	:	720-242-5816
Fax Number	:

Provider Business Practice Location Address
First Line	:	5335 S VALENTIA WAY APT 251
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-3115
Country	:	US
Telephone Number	:	720-242-5816
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. JANELLE L LOMHEIM
Credential	:
Telephone Number	:	720-242-5816

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	12/01/2017

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